FIGURE 3.

Overview of catabolic factors during hemodialysis and anabolic interventions that may be applied during this period. During a hemodialysis session, patients typically have low levels of dietary intake and physical activity, while the procedure removes amino acids from their circulation and activates an inflammatory cascade. This results in a catabolic period during hemodialysis, which promotes the loss of muscle mass and strength. Interventions to support muscle maintenance that can be applied during hemodialysis include dietary counseling to improve habitual dietary intake, providing protein-rich foods, prescribing physical activity, and counseling to increase habitual physical activity levels.