Long-term oral nutrition supplementation improves outcomes in malnourished patients with chronic kidney disease on hemodialysis.
BACKGROUND
There is no consensus on the type, time of initiation, or duration of use of enteral nutrition in patients with chronic kidney disease (CKD). This study aimed to compare the effects of a renal-specific oral nutrition supplement (RS-ONS) and a standard recommended nutrition regime on biochemical and nutrition markers in malnourished patients with CKD on hemodialysis.


METHODS
Sixty-two malnourished patients with CKD, divided into experimental (RS-ONS; n = 32; mean [SD] age, 62.0 [11.3] years; 55.2% female) and control (CON; n = 30; mean [SD] age, 57.2 [12.3] years; 31% female) groups, were evaluated for anthropometric, biochemical, and inflammatory parameters.


RESULTS
Mean (SD) serum albumin levels were significantly increased in the RS-ONS group from 3.5 (0.3) g/dL at baseline to 3.7 (0.2) g/dL at 6 months (P = .028). Significantly fewer patients had serum albumin levels of <3.5 g/dL after month 6. Dry weight of patients significantly increased in the RS-ONS but decreased in the CON groups (P < .001 for each). Percent change from baseline revealed negative results for bioelectrical impedance analysis (P < .001) in the CON group. Malnutrition inflammation score at 6 months (P = .006) and erythropoietin (EPO) dose requirements were higher in the CON group (P = .012).


CONCLUSIONS
Our findings indicate that consuming RS-ONS improves serum albumin and anthropometric measures, as well as reduces EPO dose, in patients with CKD.
Department of Nephrology, Baskent University Faculty of Medicine, Ankara, Turkey sirensezer@hotmail.com.
Siren
S
Sezer
Department of Nephrology, Baskent University Faculty of Medicine, Ankara, Turkey.
Zeynep
Z
Bal
Department of Nephrology, Baskent University Faculty of Medicine, Ankara, Turkey.
Emre
E
Tutal
Department of Nephrology, Baskent University Faculty of Medicine, Ankara, Turkey.
Mehtap Erkmen
ME
Uyar
Department of Nephrology, Baskent University Faculty of Medicine, Ankara, Turkey.
Nurhan Ozdemir
NO
Acar
D000284:Administration, Oral; D000368:Aged; D001835:Body Weight; D019587:Dietary Supplements; D017097:Electric Impedance; D004921:Erythropoietin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000097:blood / Q000178:diet therapy* / Q000209:etiology; D008875:Middle Aged; D009752:Nutritional Status; D006435:Renal Dialysis / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy*; D012709:Serum Albumin / Q000378:metabolism*
D012709:Serum Albumin; D004921:Erythropoietin
anthropometrics; chronic renal disease; dialysis; malnutrition; oral nutritional supplements