engleski

Effects of oral nutritional supplementation on nutritional parameters and lean tissue mass in patients on maintenance hemodialysis - a pilot study

Introduction and aim. During hemodialysis (HD) treatment, the loss of nutrients through dialysis membrane leads to higher protein catabolism and muscular tissue waste defined as protein-energy wasting (PEW). PEW is a definite morbidity and mortality risk factor in chronic kidney disease patients, especially those on dialysis. The aim of our study was to investigate the effects of oral nutritional supplementation (ONS) therapy on nutritional parameters and lean tissue mass (LTM) status in HD patients. Methods. We included HD patients in Department of Nephrology, Dialysis and Kidney Transplantation, Clinical Hospital Centre Rijeka, from January 1, 2014, to December 31, 2014. We examined serum albumin, cholesterol, creatinine, total iron binding capacity (TIBC), over hydration (OH), body mass index (BMI), LTM, and performed a malnutrition inflammation score (MIS), at baseline and after six months. The patients were divided into two groups: those who were taking one package of ONS (Nepro HP®, Renilon®) daily, and those without ONS. OH and LTM were measured by multifrequency bioimpedance analysis (BIA) method with BCM – Body Composition Monitor® (Fresenius Medical Care, Bad Homburg, Germany) before the HD treatment. Results. Out of total 148 HD patients, 100 were enroled in the study (mean age 69.9 years, range 23-92 years, 50% male). Patients who were taking Renilon® were excluded for their negligible proportion (nine patients). 91 patients (47% male), of whom 47 patients in a group with ONS (Nepro HP® 220ml-1, 8 kcal/ml, Abbot Nutrition, UK), were analysed. There was no statistically significant difference in demographic and nutritional parameters between the groups, at the baseline. Serum albumin (36±2.37 vs. 41.19±2.22 ; P<0.001), and cholesterol (3.77±0.99 vs. 4.15±1.11 ; P=0.047) levels were higher in the patient group with ONS, after six months. In the patient group without ONS, there was significantly lower LTM (30.77±11.2 vs. 27.15±6.75 ; P=0.034), in comparison to the group with ONS (28.04±6.99 vs. 29.49±3.93 ; P=0.108), after six months. Conclusions. Daily ONS therapy significantly raises serum albumin and cholesterol levels in the patients on the maintenance HD, in a six months period. In the patients without taking ONS, there was a significant loss in LTM, after the same period.

oral nutritional supplementation ; nutritional parameters ; lean tissue mass ; hemodialysis

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