Effects of Intradialytic Nutrition on Dialysis Adequacy and Fatigue

This randomized, two-period, two-sequence crossover trial aims to evaluate the effects of intradialytic nutrition on dialysis adequacy, intradialytic hemodynamic parameters, and fatigue in adults receiving maintenance hemodialysis. Participants will receive standardized intradialytic nutrition during one study period and no food intake during the other period, with each participant serving as their own control. Dialysis adequacy will be assessed using the urea reduction ratio (URR) and single-pool Kt/V (spKt/V), while fatigue will be evaluated using the Piper Fatigue Scale. Intradialytic blood pressure and other clinical parameters will also be monitored throughout the study. The findings are expected to provide evidence regarding the safety and clinical effects of intradialytic nutrition and to support individualized nutritional management strategies for patients undergoing maintenance hemodialysis.

Inclusion Criteria: * Adults aged 18 years or older. * Receiving maintenance hemodialysis three times per week for at least 3 months. * Clinically stable. * Able to provide written informed consent. Exclusion Criteria: * Active infection. * Hospitalization within the previous month. * Gastrointestinal disorders affecting oral intake. * Severe intradialytic hypotension requiring frequent intervention (MAP \