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. 2022 Dec 16;14(24):5352.
doi: 10.3390/nu14245352.

Effects of the Malnutrition-Eat Additional Meal (MEAM) Diet on the Serum Levels of Albumin and C-Reactive Protein in Hemodialysis Patients

Lucyna Kozlowska  1 , Jolanta Gromadzinska  2 , Rafal Zwiech  3 , Zbigniew Zbrog  4 , Wojciech Wasowicz  2
Affiliations

Effects of the Malnutrition-Eat Additional Meal (MEAM) Diet on the Serum Levels of Albumin and C-Reactive Protein in Hemodialysis Patients

Lucyna Kozlowska et al. Nutrients. .

Abstract

The main objective of this project was to evaluate the efficiency of two kinds of nutritional intervention implemented in hemodialysis patients for 24 weeks (traditional nutritional intervention without a meal served before dialysis for group HG1, and nutritional intervention involving a meal served before dialysis for group HG2), and their impact on nutritional status and serum concentrations of C-reactive protein (CRP). Nutritional status and serum biochemical parameters were analyzed in the control group (CG, n = 70) and in two homogeneous groups of patients, HG1 (n = 35) and HG2 (n = 35). There was an interesting trend in both groups of patients connected with increased intake, mainly of energy and protein. In HG1, the greatest increase in energy intake was observed on Sundays, and in HG2 on the days with dialysis. In HG2, after 24 weeks of the nutritional intervention, an increase in serum albumin (p = 0.0157) and a decrease in CRP concentration (p = 0.0306) were observed, whereas in HG1 there was a decrease in serum albumin concentration (p = 0.0043) with no significant change in CRP concentration. The nutritional intervention applied, called the Malnutrition-Eat Additional Meal (MEAM) diet with an easily digestible meal served before dialysis, was aimed at improving the patients' nutritional status and the obtained results indicate the need not only for substantial reeducation of hemodialysis patients in the area of their diet, but also for undertaking further research and discussions on the possibility of ensuring adequate meals for hemodialysis patients before the dialysis procedure.

Keywords: dietary intervention; inflammation; nutritional status.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The work plan of the studies: healthy people (control group, CG) and nutritional intervention in 2 homogeneous groups of patients treated with hemodialysis.
Figure 2
Figure 2
(A,B) Differences between daily energy intake (kcal/d) in comparison to the control group (CG) and in comparison to baseline values (week 0). (A)—data regarding patients who were to comply with the dietary recommendations without a meal served before dialysis (HG1); (B)—data regarding patients who were to comply with the dietary recommendations with a meal served before dialysis (HG2); WD—a day with dialysis; WOD—a day without dialysis; Su—Sunday.
Figure 3
Figure 3
(A,B) Differences between daily protein intake (g/d) in comparison to the control group (CG) and in comparison to baseline values (week 0). (A)—data regarding patients who were to comply with the dietary recommendations without a meal served before dialysis (HG1); (B)—data regarding patients who were to comply with the dietary recommendations with a meal served before dialysis (HG2); other abbreviations as in Figure 2.
Figure 4
Figure 4
(A,B) Serum concentration of albumin (A) and CRP (B) in the studied groups of participants at baseline (week 0) and after 24 weeks of the dietary intervention. CRP—C-reactive protein; w.0—week 0; w.24—week 24; other abbreviations as in Figure 2.
Figure 5
Figure 5
(A,B) Relationship between the serum concentration of albumin at baseline (in week 0) and changes in this parameter after 24 weeks of the nutritional intervention in HG1 (A) and HG2 (B). Abbreviations as in Figure 2.
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