{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T03:02:11Z","timestamp":1778036531945,"version":"3.51.4"},"reference-count":29,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Nutritional status is essential for outcomes in hemodialysis (HD) patients. Incremental HD (iHD) may help preserve residual renal function, but its effect on nutrition and body composition is unclear. Nutritional ultrasound (NUS) offers a non-invasive way to assess muscle and fat, complementing methods like BIA. This study compared nutritional status using morphofunctional assessment in patients on iHD versus conventional HD (cHD). Material and Methods: This single-center observational cross-sectional study included 74 stable adult HD patients (&gt;3 months). Patients were stratified into iHD (n = 13; 1\u20132 sessions\/week) and cHD (n = 61; 3 sessions\/week). Evaluations included clinical and biochemical parameters, BIA, handgrip strength, nutritional scores and NUS assessed mass muscle of anterior quadriceps rectus femoris (QRF), supramuscular fat (SMF), subcutaneous adipose tissue (SAT), and preperitoneal visceral fat (PPVF). Results: Patients on iHD exhibited a more favorable nutritional and inflammatory profile, with a lower risk of malnutrition and a reduced prevalence of protein-energy wasting (PEW) syndrome. Although BIA failed to clearly differentiate between groups, NUS identified better preservation of SMF in iHD patients (8.3 \u00b1 2.5 vs. 6.6 \u00b1 2 mm; p = 0.009), as well as higher preperitoneal visceral fat thickness (1.9 \u00b1 4.9 vs. 0.6 \u00b1 0.3 cm; p = 0.04). There was also a trend toward greater muscle thickness in the iHD group, such as the Y-axis (9.5 \u00b1 2 vs. 8.5 \u00b1 2.3 mm; p = 0.17) and cross-sectional area muscle of rectus femoris (CS-MARF in cm2) (2.9 \u00b1 0.6 vs. 2.6 \u00b1 0.8 mm; p = 0.1) of anterior QRF, although without reaching statistical significance. Conclusions: These results highlight the value of NUS as a sensitive method for assessing nutritional status in HD patients, particularly within individualized strategies such as iHD, where it may provide key complementary information not captured by conventional methods.<\/jats:p>","DOI":"10.3390\/medicina61091633","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T19:16:17Z","timestamp":1757445377000},"page":"1633","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Nutritional Ultrasound in the Morphofunctional Assessment of Malnutrition in Patients Undergoing Incremental Versus Conventional Hemodialysis: A Comparative Study"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3005-7039","authenticated-orcid":false,"given":"Elena","family":"Jim\u00e9nez Mayor","sequence":"first","affiliation":[{"name":"Department of Nephrology, Hospital San Pedro de Alc\u00e1ntara, 10001 C\u00e1ceres, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 C.","family":"De La Flor","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Central de la Defensa G\u00f3mez Ulla, 28047 Madrid, Spain"},{"name":"Department of Medicine and Medical Specialties, Faculty of Medicine, Alcala University, 28805 Madrid, Spain"},{"name":"Health Sciences Doctoral Program, Faculty of Medicine, Alcala University, 28805 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0633-6325","authenticated-orcid":false,"given":"Avinash","family":"Chandu Nanwani","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital General de Fuerteventura, 35600 Fuerteventura, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9873-3043","authenticated-orcid":false,"given":"Celia","family":"Rodr\u00edguez Tudero","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitario de Salamanca, 37007 Salamanca, Spain"},{"name":"Surgery Doctoral Program, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4538-3503","authenticated-orcid":false,"given":"Estefanya","family":"Garc\u00eda-Men\u00e9ndez","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitario Puerta de Hierro Majadahonda, 28222 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raul","family":"Elias","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Cayetano Heredia, Lima 15002, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3462-9997","authenticated-orcid":false,"given":"Hemily","family":"Chimoy","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Guillermo Almenara, Lima 15001, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Dominguez Davalos","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Cayetano Heredia, Lima 15002, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6558-7231","authenticated-orcid":false,"given":"Michael","family":"Cieza Terrones","sequence":"additional","affiliation":[{"name":"Department of Engineering, Faculty of Science and Engineering, Peruana Cayetano Heredia University, Lima 15012, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3704-0255","authenticated-orcid":false,"given":"Francisco","family":"Valga","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Doctor Negrin University Hospital of Gran Canaria, 35010 Las Palmas de Gran Canaria, Spain"},{"name":"Department of Medicine, University Fernando Pessoa-Canarias, 35450 Santa Maria de Guia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jes\u00fas","family":"Hern\u00e1ndez Vaquero","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Central de la Defensa G\u00f3mez Ulla, 28047 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S7","DOI":"10.1111\/j.1523-1755.2005.09801.x","article-title":"Chronic renal diseases as a public health 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