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Abstract: SA-PO1062

Effect of Intra-Dialysis Nutrients Admixture vs Conventional Intra-Dialysis Parenteral Nutrition on Nutrition Status and Inflammation in Malnourished Hemodialysis Patients

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1302 Health Maintenance, Nutrition, and Metabolism: Clinical

Authors

  • Supasyndh, Ouppatham, Phramongkutklao hospital, Bangkok, Thailand
  • Boonkarn, Wongsakorn, Phramongkutklao hospital, Bangkok, Thailand
  • Tangwonglert, Theerasak, Phramongkutklao hospital, Bangkok, Thailand
  • Tasanavipas, Pamila, Phramongkutklao hospital, Bangkok, Thailand
  • Chaiprasert, Amnart, Phramongkutklao hospital, Bangkok, Thailand
  • Nata, Naowanit, Phramongkutklao hospital, Bangkok, Thailand
  • Satirapoj, Bancha, Phramongkutklao hospital, Bangkok, Thailand
Background

Protein/caloric malnutrition and inflammation is a major problem in long-term hemodialysis patients. Total nutrients admixture containing 80% olive oil-base intravenous lipid emulsions and low proportion of polyunsaturated fatty acids may offer several advantages such as a reduction of oxidative and inflammatory effects in end stage renal disease (ESRD).

Methods

The study was a randomized controlled trial; patients with malnourished ESRD on hemodialysis were randomly assigned into an admixture-IDPN group (n=13) and a conventional-IDPN group (n=13). Nutritional assessment, and inflammatory markers including high sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) were measured at baseline and 4 weeks following intervention.

Results

At the end of 4-week, nutritional parameters including serum albumin (0.41±0.18 vs 0.16±0.22, P=0.004), pre-albumin (7.88±4.6 vs. 2.01±2.63. P=0.001) and urea reduction ratio (2.92±0.76 vs 0.92±2.78, P=0.026) in the admixture-IDPN group have a significantly greater improvement than the conventional-IDPN group. The decline in serum IL-6 levels was -13.9 pg/mL larger among admixture-IDPN vs conventional-IDPN group (95% CI -20.41 to -7.4 pg/mL). The admixture-IDPN group had also higher absolute lymphocyte counts and lower hs-CRP levels after treatment, but there were no significant changes in the conventional-IDPN group. There were no statistically significant differences between the two groups in the risk of electrolytes abnormalities and adverse events.

Conclusion

Malnourished ESRD patients on dialysis receiving olive oil-base lipid emulsions and low polyunsaturated fatty acids IDPN resulted in modest improvements in nutritional status and inflammatory cytokines.