Dietary management of haemodialysis patients with chronic kidney disease and malnourishment

Abstract

Background and objectives: Dietary supplementation for haemodialyzed (HD) patients with chronic kidney disease (CKD) and its benefits for the anthropometric profiles remain contentious. This study analysed changes in the albumin levels and anthropometric profiles of HD patients within 3 months of nutritional therapy.

Methods and study design: Sixty-three malnourished HD patients (Subjective Global Assessment nutrition status B or C) were enrolled. Twenty patients received counselling, 17 patients received oral therapy, 26 patients received intradialytic parenteral nutrition (IDPN), and were evaluated at month 0, month 1, and month 3. Five patients withdrew before completing the trial. The patients' albumin levels and anthropometric profiles (biceps and triceps skinfold thickness, upper arm circumference, body weight, and body mass index) were analysed before and after treatment. We performed multivariate analysis to determine the effect of each treatment on serum albumin and anthropometric profiles.

Results: At months 1 and 3, nutritional therapy was associated with different mean serum albumin level among three nutritional intervention groups (p<0.05). Significant increases in serum albumin, upper arm circumference, and triceps and biceps skinfold thickness were identified in the counselling and IDPN groups. Multivariate linear regression revealed significant differences between oral and nonoral groups in albumin and biceps and triceps skinfold thickness at months 1 and 3. These variables were affected by age and duration of haemodialysis (p<0.05).

Conclusions: Nutritional therapy for malnourished CKD patients receiving HD ameliorated serum albumin and their anthropometric profiles within 3 months.