Kelly Owen J, Huang Meng-Chuan, Liao Hsin-Yin, Lin Chih-Ching, Tung Tsui-Yin, Cheng Rhoda Wen-Yi, Wang Michael Yao-Hsien, Yalawar Menaka, Hwang Shang-Jyh
Abbott Nutrition, Global Scientific & Medical Affairs, Columbus, OH 43219, USA.
Department of Nutrition and Dietetics, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan.
J Pers Med. 2021 Dec 14;11(12):1360. doi: 10.3390/jpm11121360.
A low-protein diet (LPD) is recommended to patients with non-dialysis advanced chronic kidney disease (CKD) for delaying renal function decline. However, this approach potentially prevents an adequate calorie and micronutrient intake. We examined the influence of an LPD including a renal-specific oral nutrition supplement (RONS) on the nutrition status of patients with stage 3b-5 CKD. This multicenter, open-label study prospectively enrolled patients over 18 years of age, with an estimated glomerular filtration rate (eGFR) between 10 and 45 mL/min/1.73 m, serum albumin ≥3.0 g/dL, and body mass index ≤30 kg/m. All participants implemented the LPD with one serving of RONS daily for 6 months. Daily energy intake, nutrition status, renal function, and quality of life were assessed before and after the intervention. Of 53 enrolled patients, 35 (66.0%) completed the study. We found that RONS use increased patients' energy intake and maintained their serum albumin, nutritional status, and quality of life. Body weight and handgrip strength increased significantly at 6 months after enrollment ( = 0.0357); eGFR slightly decreased at 3 and 6 months after enrollment, suggesting that patients' residual renal function was preserved. Our findings support the conclusion that patients with non-dialysis advanced CKD may benefit from additional RONS besides their regular diet. Patients with advanced CKD receiving RONS might achieve better nutrition and delay renal function decline.
对于非透析的晚期慢性肾脏病（CKD）患者，推荐采用低蛋白饮食（LPD）以延缓肾功能衰退。然而，这种方法可能会导致热量和微量营养素摄入不足。我们研究了包含肾脏专用口服营养补充剂（RONS）的低蛋白饮食对3b - 5期CKD患者营养状况的影响。这项多中心、开放标签研究前瞻性纳入了年龄超过18岁、估计肾小球滤过率（eGFR）在10至45 mL/min/1.73 m²之间、血清白蛋白≥3.0 g/dL且体重指数≤30 kg/m²的患者。所有参与者每天食用一份RONS并采用低蛋白饮食，持续6个月。在干预前后评估每日能量摄入、营养状况、肾功能和生活质量。在纳入的53例患者中，35例（66.0%）完成了研究。我们发现，使用RONS增加了患者的能量摄入，并维持了他们的血清白蛋白水平、营养状况和生活质量。入组6个月时体重和握力显著增加（P = 0.0357）；入组3个月和6个月时eGFR略有下降，提示患者的残余肾功能得到了保留。我们的研究结果支持以下结论：非透析晚期CKD患者除常规饮食外，额外补充RONS可能有益。接受RONS的晚期CKD患者可能会获得更好的营养状况并延缓肾功能衰退。
