Pilot study to reduce interdialytic weight gain by provision of low‐sodium, home‐delivered meals in hemodialysis patients

Introduction Patients with kidney failure undergoing maintenance hemodialysis (HD) therapy are routinely counseled to reduce dietary sodium intake to ameliorate sodium retention, volume overload, and hypertension. However, low‐sodium diet trials in HD are sparse and indicate that dietary education and behavioral counseling are ineffective in reducing sodium intake. This study aimed to determine whether 4 weeks of low‐sodium, home‐delivered meals in HD patients reduces interdialytic weight gain (IDWG). Secondary outcomes included changes in dietary sodium intake, thirst, xerostomia, blood pressure, volume overload, and muscle sodium concentration. Methods Twenty HD patients (55 ± 12 years, body mass index [BMI] 40.7 ± 16.6 kg/m2) were enrolled in this study. Participants followed a usual (control) diet for the first 4 weeks followed by 4 weeks of three low‐sodium, home‐delivered meals per day. We measured IDWG, hydration status (bioimpedance), standardized blood pressure (BP), food intake (3‐day dietary recall), and muscle sodium (magnetic resonance imaging) at baseline (0 M), after the 4‐week period of usual diet (1 M), and after the meal intervention (2 M). Findings The low‐sodium meal intervention significantly reduced IDWG when compared to the control period (−0.82 ± 0.14 kg; 95% confidence interval, −0.55 to −1.08 kg; P