Abstract: SA-PO1080
Enhancing Dialysis Outcomes Through Intradialytic Protein Supplementation: A 12-Month Quality Improvement Study
Session Information
- Kidney Replacement Therapy and Care Delivery Innovations
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Jazayeri, Firouzeh, University of Florida Health, Gainesville, Florida, United States
- Ilkun, Olesya, University of Florida, Gainesville, Florida, United States
Background
In patients with end-stage kidney disease (ESKD), nutritional status and clinical outcomes are closely interconnected. During maintenance hemodialysis (HD), inadequate protein intake and protein-energy wasting (PEW) can impair treatment tolerance, and increase morbidity and mortality. Several studies have shown that intradialytic protein supplementation may improve nutritional markers, yet there are concerns that intradialytic protein supplementation may decrease dialysis adequacy due to higher generation of urea and other metabolites. This quality improvement initiative evaluated whether intradialytic protein supplementation could improve clinical outcomes without compromising adequacy in patients receiving maintenance HD.
Methods
The patients with ESKD receiving maintenance HD at the outpatient center were enrolled if they had albumin levels below 4.0 g/dL for at least 3 months. These patients received 15 g of oral liquid protein supplement (LPS) at the end of each HD session for 12 months. Primary outcomes were serum albumin and creatinine, normalized protein catabolic rate (nPCR), and HD adequacy (Kt/V) at baseline, 6 months, and 12 months. Secondary outcomes were frequency and duration of hospitalizations at baseline and 12 months.
Results
24 patients satisfied the enrollment criteria. LPS supplementation was associated with sustained improvements in nutritional markers. Serum albumin increased from 3.59 ± 0.21 g/dL at baseline to 3.78 ± 0.19 g/dL at 12 months (p = 0.020) with the greatest gains observed during the first six months. nPCR increased and remained consistently above 1.0 g/kg/day, indicating adequate protein intake. Kt/V increased from 1.56 ± 0.21 to 1.69 ± 0.24 at 12 months. At the same time, serum creatinine increased modestly (8.46 ± 3.10 to 9.29 ± 3.04 at 12 months), suggesting stabilization of muscle mass. At 12 months, the average number of hospitalizations per month decreased from 3.7±1.03 to 2.1±1.6 (P=0.02) and the average duration of hospitalizations decreased from 5.3 to 3.2 days (P=0.02).
Conclusion
Intradialytic LPS supplementation is associated with improved albumin, nPCR, and reduced duration and frequency of hospitalizations without compromising adequacy of HD. These findings support routine intradialytic protein supplementation as an effective, practical strategy to enhance nutritional status, and mitigate PEW among high-risk HD patients.