The effects of oral protein supplementation on nutritional status in malnourished hemodialysis patients. A retrospective study

Background: Malnutrition is common in chronic hemodialysis (CHD) patients due to lower dietary protein and energy intake than normal. Morbidity and mortality rates are unacceptably high in end-stage renal disease (ESRD) patients and correlate with malnutrition status in these patients. This retrospective study aims to evaluate the nutritional effects of oral nutrition supplements (ONS) on various nutritional parameter outcomes in maintenance hemodialysis (MHD) patients based on the hypothesis that daily provision of ONS would improve or prevent further deterioration of the nutrition status of MHD patients. 

Methodology: For 34 patients who received ONS for two months, laboratory and anthropometric measurements were taken before the start of ONS intake and after two months of continuous consumption. Biochemical markers (albumin, ferritin, and uric acid), anthropometric measurement, body mass index (BMI), dry weight (DW), and inter-dialysis weight changes were statistically analyzed using SPSS software and paired-t test was used for comparison the changes in these values. 

Result: After the provision of ONS during hemodialysis there was a significant increase in serum albumin concentration from 30.6 (± 3.5) gm/L at baseline to 31.9 (± 4.1) gm/L after 2 months (P = 0.038) and inter dialysis weight change from 2.2 (± 0.91) kg at baseline to 2.6 (± 1.2) kg (P = 0.033). The other biochemical markers such as ferritin, uric acid, and anthropometric measurements (Body Mass Index (BMI) and dry weight) had no significant changes during the study. 

Conclusion: In conclusion, our findings suggest that the treatment strategy of providing ONS could be an effective therapy for malnourished patients in MHD and might have a beneficial effect against muscle loss due to catabolism during hemodialysis (HD) treatment.