Oral nutritional supplementation increases caloric and protein intake in peritoneal dialysis patients.
BACKGROUND
Malnutrition is highly prevalent in peritoneal dialysis (PD) patients and is associated with a poor prognosis. Attempts to improve nutritional status with enteral supplements have yielded poor results.


METHODS
We performed a crossover-design trial on 13 PD patients to investigate whether these patients reduce their food intake after drinking oral nutritional supplements. Patients attended three visits in which they were administered a standard oral nutritional supplement either 2 hours or 30 minutes before lunch or a placebo drink 30 minutes before lunch. Lunch was provided as a self-select buffet-style meal, and food intake was measured. Total intake was calculated by adding the nutritional content of the oral supplement.


RESULTS
Patients showed poor food intake, with mean values equaling only 18% of the recommended daily intake for calories and 34% for protein. Drinking the supplement 2 hours before lunch resulted in a significant increase compared with the placebo visit in total caloric (430 to 843 kcal; P < 0.001) and protein intake (27.6 to 41.3 g; P = 0.006). No significant difference in total intake was detected between drinking the supplement 2 hours versus 30 minutes before lunch.


CONCLUSIONS
These results indicate that oral nutritional supplements administered before a meal may significantly increase caloric and protein intakes of PD patients.
Boudville
Neil
N
Departments of General Medicine and Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia. nboudville@aol.com
Rangan
Anna
A
Moody
Harry
H
D000328:Adult; D000368:Aged; D001692:Biological Transport; D003404:Creatinine / Q000097:blood / Q000378:metabolism / Q000652:urine; D018592:Cross-Over Studies; D004044:Dietary Proteins / Q000008:administration & dosage* / Q000378:metabolism; D004045:Dietary Services / Q000379:methods; D019587:Dietary Supplements; D002149:Energy Intake / Q000187:drug effects / Q000502:physiology; D005260:Female; D006801:Humans; D006815:Hunger / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000502:physiology; D010288:Parenteral Nutrition / Q000379:methods; D010530:Peritoneal Dialysis / Q000379:methods; D010537:Peritoneum / Q000378:metabolism; D051437:Renal Insufficiency / Q000178:diet therapy; D012684:Sensory Thresholds / Q000502:physiology; D016037:Single-Blind Method
D004044:Dietary Proteins; D003404:Creatinine