Rao NS, Chandra A, Saran S, et al. - Researchers performed a comparison between predialysis or mid-dialysis administration of oral nutritional supplements (ONS), focusing on the impacts on hemodynamics, dialysis adequacy, urea removal, and tolerability, in this single-center, prospective crossover study. They analyzed 72 stable patients suffering from ESRD on twice a week maintenance hemodialysis with a mean age of 38.7 (±11.2) years and a dialysis vintage of 28.2 (±13.1) months. All patients were administered ONS (450 kcal energy, 20 g protein) 1 h before initiation of dialysis (group 1) in the first week and for the next week, the supplement was given following 2 h of initiation of dialysis (group 2), with a predialysis fasting span of at least 3 h in both groups. According to findings, better dialysis adequacy and urea removal were conferred by predialytic supplementation vs intradialytic supplementation. However, the tolerability of both timings was equal and both were not related to underdialysis.