Effect of high-protein supplemental therapy on subjective global assessment of CKD-5D patients

Abstract

Adequate nutrition in patients on hemodialysis is an important step for improving the quality of life. This prospective study was undertaken to monitor the nutritional status of patients who were given high-protein supplements on malnutrition inflammation score (MIS) and to correlate with biochemical parameters in maintenance hemodialysis (MHD) patients. This prospective study was conducted on 55 chronic kidney disease patients on MHD (37 women, 18 men), aged between 21 and 67 years. Of the 55 patients, 26 patients received high-protein commercial nutritional supplements, whereas 29 patients received high-protein kitchen feeding. Every patient had their MIS, 24-hour dietary recall, hand grip, mid arm circumference, triceps skin-fold thickness at 0, 3, and 6 months. Each of the above parameters was compared between the high-protein commercial nutritional supplement cohort and high-protein kitchen feeding cohort, and the data were analyzed. Of the 55 patients, 82.61% of patients on high-protein kitchen feeding group and 66.67% in high-protein commercial nutritional supplement group were nonvegetarian (P = 0.021). According to the MIS, improvement was observed in malnutrition status from 3- to 6-month period in 38.1% of patients in high-protein commercial supplement group, whereas only in 8.7% in high-protein kitchen feeding group (P = 0.04). Assessment showed improvement in malnutrition status with high-protein commercial nutritional supplement, which was marked in patients with age group >65 years (P = 0.03) and in those in whom serum albumin is <35 g/L (P = 0.02). Both high-protein kitchen feeding and high-protein commercial nutritional supplement cohorts were observed to have improvement in overall nutritional status. Older patients >65 years with lower serum albumin levels (<3.5 g/dL) were observed to have significant improvement in nutritional status with high-protein commercial nutritional supplements.

Keywords: Nutrition; hemodialysis; protein supplement.