Kidney Week

Abstract: TH-PO831

Intradialytic Oral Nutrition on Clinical Outcomes in Malnourished ESRD on Hemodialysis Patients: A Randomized Controlled Trial

Session Information

• Health Maintenance, Nutrition, Metabolism
  November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Health Maintenance‚ Nutrition‚ and Metabolism

• 1400 Health Maintenance‚ Nutrition‚ and Metabolism

Authors

• Apiyangkool, Tanin, Phramongkutklao College of Medicine, Bangkok, Thailand

Tanin Apiyangkool,

• Thimachai, Paramat, Phramongkutklao College of Medicine, Bangkok, Thailand

Paramat Thimachai,

• Tasanavipas, Pamila, Phramongkutklao College of Medicine, Bangkok, Thailand

Pamila Tasanavipas,

• Siriwattanasit, Narongrit, Phramongkutklao College of Medicine, Bangkok, Thailand

Narongrit Siriwattanasit,

• Inkong, Pitchamon, Phramongkutklao College of Medicine, Bangkok, Thailand

Pitchamon Inkong,

• Varothai, Narittaya, Phramongkutklao College of Medicine, Bangkok, Thailand

Narittaya Varothai,

• Chaiprasert, Amnart, Phramongkutklao College of Medicine, Bangkok, Thailand

Amnart Chaiprasert,

• Nata, Naowanit, Phramongkutklao College of Medicine, Bangkok, Thailand

Naowanit Nata,

• Tangwonglert, Theerasak, Phramongkutklao College of Medicine, Bangkok, Thailand

Theerasak Tangwonglert,

• Kaewput, Wisit, Phramongkutklao College of Medicine, Bangkok, Thailand

Wisit Kaewput,

• Supasyndh, Ouppatham, Phramongkutklao College of Medicine, Bangkok, Thailand

Ouppatham Supasyndh,

• Satirapoj, Bancha, Phramongkutklao College of Medicine, Bangkok, Thailand

Bancha Satirapoj,

Background

Oral nutritional supplementation (ONS) is recommended for malnourished hemodialysis patients when nutritional intake remains inadequate to meet energy and protein requirements. Hemodialysis induces a negative nitrogen balance, hence oral intradialytic supplements might be an option for well-nourished patients, compensating for the loss of proteins during hemodialysis sessions. The study aimed to evaluate intradialytic ONS supplements (INTRA-ONS) compared with interdialytic ONS supplements (INTER-ONS) on nutritional status in patients on hemodialysis.

Methods

Patients were randomized in two groups; INTRA-ONS group (N=16) received specific renal formula 370 kcal/day three time per weeks during each hemodialysis session and INTER-ONS group (N=16) received same ONS three time per weeks on day without hemodialysis for 12 weeks. All patients were counseled by the same registered dietitian during the study. The nutritional status was evaluated using malnutrition inflammation score (MIS) assessment, serum albumin, and anthropometric measurements at baseline and 12 weeks.

Results

Total MIS decreased significantly among patients in the INTRA-ONS (-6.12, 95%CI -8.26 to -3.96) and INTER-ONS group (-3.50, 95%CI - 5.65 to -1.35), while a significant difference in changes of MIS was found among the two groups (-3.06%, 95% -5.94 to -0.17, P=0.038). Additionally, serum albumin (0.31 g/dL, 95%CI 0.14 to 0.47) and body weight (1.05 kg, 95%CI 0.36 to1.74) increased significantly in the INTRA-ONS group, whereas no significant change was found in the INTER-ONS group. No significant change was observed between groups by treatment effects regarding anthropometric measurements, body weight or physical function. No serious adverse effects were reported in any group.

Conclusion

Dietary advice combined with oral nutritional supplementation given during hemodialysis improves malnutrition inflammation score among malnourished ESRD patients undergoing maintenance hemodialysis.