Dialysis Frequency as a Determinant of Nutritional Status: Evidence on BMI and Bone Mass in Haemodialysis Patients

Abstract

The frequency of haemodialysis sessions is an important determinant of the nutritional status of patients with end-stage renal disease. Among anthropometric indicators, body mass index (BMI) and body composition parameters estimated by bioelectrical impedance are commonly used to assess nutritional balance and the risk of morbidity and mortality. Several studies have reported that a higher dialysis frequency (≥ 3 session per week) improves uraemic toxin clearance, protein-energy metabolism, and chronic inflammation, thereby helping to stabilise BMI and preserve lean tissue. Conversely, reduced dialysis frequency is often associated with fluid overload, increased catabolism, and poor appetite, contributing to progressive undernutrition. This cross-sectional, descriptive study included 132 haemodialysis patients from several nephrology departments in Togo, with exhaustive sampling. BMI and body composition were measured using a ZOETOUCH impedancemeter scale. Results showed that a notable proportion of patients had low BMI, ranging from 7.63% to 10.69% across different durations of haemodialysis, without a clear trend with dialysis vintage. These findings suggest that dialysis frequency may contribute to better preservation of nutritional status, but its impact must be interpreted within a multidimensional framework that also accounts for diet quality, inflammation, and biochemical parameters.