P738 - IMPACT OF MEDIUM CUT-OFF HEMODIALYSIS ON BODY COMPOSITION AND NUTRITIONAL STATUS IN OLDER ADULTS WITH ESRD

P738

IMPACT OF MEDIUM CUT-OFF HEMODIALYSIS ON BODY COMPOSITION AND NUTRITIONAL STATUS IN OLDER ADULTS WITH ESRD

B. Haktaniyan^1,*, G. Kumru², N. Yumuk³, S. Kutlay², M. Varli⁴

¹Geriatrics, ²Nephrology, ³Nutrition and Dietetics, ⁴Department of Geriatric Medicine, Ankara University, Ankara , Türkiye

Rationale: Medium cut-off (MCO) dialyzers have been proposed to enhance the removal of middle molecules and potentially improve nutritional and metabolic parameters in hemodialysis patients. This study aimed to assess the impact of MCO membrane use on body composition, nutritional intake, physical performance, and inflammation in older adults undergoing regular hemodialysis.

Methods: Twenty-one patients aged ≥60 years (mean age 69.4±5.2 years; mean dialysis duration 74.5±48.7 months) receiving thrice-weekly hemodialysis with MCO membranes were prospectively evaluated over 3 months. Assessments included anthropometry, bioimpedance analysis (BIA), handgrip strength, physical performance tests (5-chair stand and gait speed), nutritional screening (Mini Nutritional Assessment), dietary records, frailty (FRAIL scale), depression (GDS), and laboratory parameters including albumin and CRP.

Results: Daily average energy and protein intakes were 1014±188 kcal and 49.3±11.1 g, respectively. No significant changes were observed in BMI, waist circumference, body fat percentage, or lean mass. However, significant improvement was noted in the 5-chair stand test (13.4±6.2 to 12.4±4.3 seconds; p=0.001), and a trend toward improved gait speed. Depression scores significantly improved (p=0.023). CRP decreased and albumin levels remained stable, though not statistically significant. Notably, lambda levels significantly decreased (p<0.001), and the kappa/lambda ratio increased (p=0.001), indicating changes in middle molecule clearance.

Conclusion: MCO dialysis may contribute to improved physical performance and inflammation modulation in older adults without compromising nutritional status or muscle mass. Further studies with larger sample sizes and control groups are warranted.

Disclosure of Interest: None declared