Kitiya Janjiraporn, Chantaramungkorn Thun, Pantoe Apinya, Chupeerach Chaowanee, Trachootham Dunyaporn
Master Program in Toxicology and Nutrition for Food Safety, Institute of Nutrition Mahidol University Nakhon Pathom Thailand.
Hemodialysis Center Rajavej ChiangMai Hospital Chiang Mai Thailand.
Food Sci Nutr. 2024 Nov 12;12(12):10507-10516. doi: 10.1002/fsn3.4578. eCollection 2024 Dec.
Excessive water consumption from liquid or reconstituted oral nutrition supplements may increase risk of fluid overload in renal patients. Nutri-jelly, a ready-to-eat texture-modified diet with 52.8% water, some protein, low potassium, phosphorus, and sodium, could be an alternative. However, its safety is unknown for adults undergoing hemodialysis (HD). This study investigated the short-term physiological safety of Nutri-Jelly intake and its preliminary impact on renal outcomes. A randomized open-label, single-arm, two-sequence, two-period cross-over trial was conducted in 20 adults undergoing HD with inadequate protein intake (0.50 - 0.70 g/ kg body weight/day). Participants were randomly allocated into 2 groups ( =10 each) and assigned in random sequence into both Without-Jelly (HD 3 times during 7 days) and With-Jelly periods (100 g Nutri-Jelly twice daily along with HD 3 times during 7 days). A two-week washout was between the periods. Outcome measures included adverse symptoms, changes in body weight, heart rate, blood pressure, and blood biochemical parameters relevant to renal outcomes. The results showed no intervention-related adverse symptoms or significant changes in body weight, heart rate, systolic blood pressure, creatinine, albumin, and sodium. Potassium level and pre-HD diastolic blood pressure were better controlled during the With Jelly than the Without Jelly Periods ( < 0.01 and < 0.05, respectively). The eGFR was improved with no significant difference between the periods. The findings suggest that continuous intake of 100 g Nutri-Jelly twice daily for 7 days is safe in adults undergoing hemodialysis. Its efficacy on renal-related parameters warrants further investigations in long-term studies.
通过液体或复水性口服营养补充剂过量摄入水分可能会增加肾病患者发生液体过载的风险。营养果冻是一种即食的质地改良饮食，含水量为52.8%，含有一些蛋白质，低钾、磷和钠，可能是一种替代选择。然而，对于接受血液透析（HD）的成年人来说，其安全性尚不清楚。本研究调查了摄入营养果冻的短期生理安全性及其对肾脏结局的初步影响。对20名蛋白质摄入量不足（0.50 - 0.70克/千克体重/天）的接受血液透析的成年人进行了一项随机开放标签、单臂、两序列、两期交叉试验。参与者被随机分为2组（每组 = 10人），并随机顺序分配到无果冻期（7天内进行3次血液透析）和有果冻期（每天两次，每次100克营养果冻，同时7天内进行3次血液透析）。两期之间有两周的洗脱期。观察指标包括不良症状、体重、心率、血压的变化以及与肾脏结局相关的血液生化参数。结果显示，没有与干预相关的不良症状，体重、心率、收缩压、肌酐、白蛋白和钠也没有显著变化。与无果冻期相比，有果冻期的血钾水平和透析前舒张压得到了更好的控制（分别为P < 0.01和P < 0.05）。两期之间估算肾小球滤过率（eGFR）有所改善，但差异无统计学意义。研究结果表明，对于接受血液透析的成年人，连续7天每天两次摄入100克营养果冻是安全的。其对肾脏相关参数的疗效值得在长期研究中进一步探讨。
