The Other Side of the Coin: Interdialytic Weight Gain as an Index of Good Nutrition

Abstract Excessive interdialytic weight gain (IDWG) is usually attributed to fluid and sodium overload. Abnormal thirst regulation, hormonal derangements, and social, cultural, and psychological habits may account for low compliance with fluid and salt restrictions. However, food intake is an important determinant of IDWG, and high IDWG may reflect the nutritional status of hemodialyzed patients, rather than their scanty compliance. The relationship between IDWG, efficacy of dialysis, and nutritional status was investigated in 38 patients (28 men and 10 women), in whom urea kinetics was studied by means of an on- line urea sensor (UM 1000, Baxter Healthcare, McGraw Park, IL), and Kt/V and protein catabolic rate (PCR) were calculated. Records from 161 dialysis sessions were analyzed and grouped according to their IDWG (group A, weight gain > 5% and group B, weight gain