Effect of an AI-Based Dietary Self-Assessment System on Nutritional Management in Maintenance Hemodialysis Patients: A Randomized Controlled Trial

 

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Effect of an AI-Based Dietary Self-Assessment System on Nutritional Management in Maintenance Hemodialysis Patients: A Randomized Controlled Trial

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Xintong
Han
Xintong Han 422866398@qq.com The First Hospital of Jilin University Blood Purification Center Changchun China *
Hui Zhong 18744029647@163.com The First Hospital of Jilin University Blood Purification Center Changchun China -
Liting He 2672595112@qq.com The First Hospital of Jilin University Blood Purification Center Changchun China -
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To evaluate the efficacy of an artificial intelligence (AI)-powered dietary self-assessment system in improving nutritional status and biochemical parameters among maintenance hemodialysis (MHD) patients.

A prospective randomized controlled trial was conducted, enrolling 160 MHD patients from a tertiary hospital between January 2024 and June 2025. Participants were randomized into an AI intervention group (*n*=80) and a conventional control group (*n*=80). The control group received standard dietitian guidance, while the intervention group used a proprietary AI dietary management system integrating image recognition, personalized recommendations, and real-time feedback. The system, aligned with Chinese CKD nutrition guidelines, analyzed daily uploaded food images to estimate sodium, phosphorus, potassium, and protein intake, generating a dynamic nutrition score (0–100). Over 3 months, primary outcomes included serum phosphorus, potassium, and albumin levels; secondary outcomes comprised MNA-SF nutritional scores, KDQOL-36 quality of life scales, and dietary adherence rates.

The AI group showed a 23.5±6.2-point improvement in dietary scores (vs. 8.1±4.7 in controls, P<0.001), with 68.4% achieving target scores (≥80) (vs. 31.6%, P=0.002). Biochemically, the AI group reduced serum phosphorus from 2.21±0.43 mmol/L to 1.76±0.38 mmol/L (vs. 2.19±0.41→1.98±0.39 mmol/L in controls, between-group P=0.013), with a 62% lower hyperkalemia incidence (6.3% vs. 16.9%, P=0.041). Nutritional status improved significantly: MNA-SF scores increased by 4.2±1.1 points (vs. 1.8±0.9, P<0.001), and hypoalbuminemia (<35g/L) decreased from 28.9% to 12.5% (vs. 27.5%→23.8%). Patients used the AI system 2.3±0.8 times daily, with 87% endorsing recipe accuracy. Multivariate analysis revealed each 10-point dietary score increase reduced hyperphosphatemia risk by 34% (OR=0.66, 95%CI 0.52–0.83).

The AI-driven dietary self-assessment system significantly enhanced dietary adherence and metabolic control (e.g., hyperphosphatemia) in MHD patients. Its image recognition and personalized feedback offer a scalable solution for chronic disease nutrition management.

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