Department of Medicine, Chaiyaphum Hospital, Bangkok, Thailand.
Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand.
Int Urol Nephrol. 2021 Aug;53(8):1675-1687. doi: 10.1007/s11255-020-02768-5. Epub 2021 Jan 16.
Malnutrition is highly prevalent and a consequence of inflammation and related comorbidities among patients on maintenance hemodialysis. Oral nutritional supplementation (ONS) is recommended for malnourished patients with kidney failure. The study aimed to evaluate renal-specific oral nutrition (ONCE dialyze) supplement on nutritional status in patients on hemodialysis.
Patients were randomized into 3 groups; treatment groups received 370 kcal/day of ONCE Dialyze (N = 26) or 370 kcal/day of NEPRO (N = 30) for 30 days. The control group (N = 24) received no intervention. All patients were counseled by the same registered dietitian during the study. The nutritional status was evaluated using malnutrition inflammation score (MIS) assessment, body compositions, serum albumin and pre-albumin levels at baseline and 30 days.
Eighty patients were analyzed with mean age of 57.2 ± 15.9 years. The intervention group exhibited significant improvements in energy, protein, fat, fiber and magnesium intake by dietary interview compared with the control group. Percentage of changes in MIS was - 29.0% (95% CI - 40.5 to - 17.4), - 23.9% (95% CI - 37.2 to - 10.6) and 12.1% (95% CI - 19.2 to 43.4) for the ONCE dialyze, NEPRO and control groups, respectively (overall P = 0.006). Percentage of changes in serum albumin was 5.3% (95% CI 1.9-8.7), 3.3% (95% CI - 0.1 to 6.7) and - 0.8% (95% CI - 4.3 to 2.7) for the ONCE dialyze, NEPRO, and control groups, respectively (overall P = 0.039; P = 0.043 for ONCE dialyze vs. control). No serious adverse effects were reported in any group.
Dietary advice combined with ONS especially ONCE dialyze was associated with improved MIS, serum albumin, dietary energy and macronutrient intake among patients with kidney failure on maintenance hemodialysis.
TCTR20200801001.
营养不良在维持性血液透析患者中普遍存在，是炎症和相关合并症的后果。对于肾衰竭的营养不良患者，推荐口服营养补充（ONS）。本研究旨在评估肾脏专用口服营养（ONCE dialyze）补充剂对血液透析患者的营养状况的影响。
将患者随机分为 3 组；治疗组分别接受 370 千卡/天的 ONCE Dialyze（N=26）或 370 千卡/天的 NEPRO（N=30），持续 30 天。对照组（N=24）未接受干预。在研究期间，所有患者均由同一位注册营养师进行咨询。使用营养不良-炎症评分（MIS）评估、身体成分、血清白蛋白和前白蛋白水平来评估营养状况，在基线和 30 天时进行评估。
共分析了 80 例患者，平均年龄为 57.2±15.9 岁。与对照组相比，干预组通过饮食访谈显示能量、蛋白质、脂肪、纤维和镁的摄入量有显著改善。MIS 的变化百分比分别为 -29.0%（95%CI-40.5 至-17.4）、-23.9%（95%CI-37.2 至-10.6）和 12.1%（95%CI-19.2 至 43.4），ONCE dialyze、NEPRO 和对照组分别为 12.1%（95%CI-19.2 至 43.4）（总体 P=0.006）。血清白蛋白的变化百分比分别为 5.3%（95%CI1.9-8.7）、3.3%（95%CI-0.1 至 6.7）和-0.8%（95%CI-4.3 至 2.7），ONCE dialyze、NEPRO 和对照组分别为 0.8%（95%CI-4.3 至 2.7）（总体 P=0.039；ONCE dialyze 与对照组相比，P=0.043）。任何一组均未报告严重不良事件。
饮食建议联合 ONS 特别是 ONCE dialyze 可改善肾衰竭维持性血液透析患者的 MIS、血清白蛋白、膳食能量和宏量营养素摄入。
TCTR20200801001。
