Tohoku J. Exp. Med., 2023 June, 260(2)

Extended-Hours Hemodialysis without Dietary Restrictions Increases Body Mass Index and Normalizes Hypertension: A Case Report

Hiroshi Kaneda,¹ Toshiro Nishiyama,² Kazunori Owada,¹ Koichi Katayose,¹ Yutaka Takagi,¹ Shigefumi Ishikawa,³ Shiro Tabata⁴ and Fumika Kaneda¹

¹Department of Nephrology, Kamome Clinic, Iwaki, Fukushima, Japan
²Department of Medical Engineering, Kamome Clinic, Iwaki, Fukushima, Japan
³Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
⁴Department of Orthopaedic Surgery, Kamome Clinic, Iwaki, Fukushima, Japan

Dialysis technology has made remarkable progress. However, many patients still suffer from malnutrition and hypertension. They cause many complications and significantly impact patients' quality of life and prognosis. To solve these problems, we developed a new dialysis modality, extended-hours hemodialysis without dietary restrictions. Here we report a case of a man who has received this treatment for 18 years. He had been on conventional hemodialysis (three times a week for 4 hours) since his dialysis initiation. He suffered from hypertension and was on five antihypertensive drugs to control his blood pressure. In addition, dietary restrictions were strict, and the nutritional status was somewhat poor. After being transferred to our clinic, the dialysis time was gradually extended to 8 hours, and dietary restrictions were greatly relaxed. Interestingly, his body mass index (BMI) increased, and his hypertension was controlled. After 3 years, he stopped all antihypertensive drugs. This result suggests that improving nutritional status may control hypertension. However, salt intake was substantially increased. Serum phosphorus and serum potassium levels were at a slightly higher level but were controlled by medications. At the time of transfer, anemia was treated with erythropoiesis-stimulating agents and glycated iron oxide, but these drugs were gradually reduced and discontinued. However, he maintained high average erythrocyte counts and normal hemoglobin levels. Dialysis conditions were wholly slow dialysis, lower than conventional dialysis methods, but the dialysis efficiency was satisfactory. In conclusion, we speculate that extended-hours hemodialysis without dietary restrictions reduces the risk of malnutrition and hypertension.

Key words —— BMI; extended-hours hemodialysis without dietary restrictions; glycosaminoglycans; hypertension; malnutrition

© 2023 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2023 June, 260(2), 135-140.

Correspondence: Toshiro Nishiyama, Department of Medical Engineering, Kamome Clinic, 5-8 Kusakidai, Iwaki, Fukushima 972-8301, Japan.

e-mail: t.nishiyama@kamome-clinic.com