Amino acid profile after oral nutritional supplementation in hemodialysis patients with protein-energy wasting

• Published in: Nutrition (Burbank, Los Angeles County, Calif.) Los Angeles County, Calif.), 2019-01, Vol.57, p.231-236
• Main Authors: Małgorzewicz, Sylwia, Gałęzowska, Grażyna, Cieszyńska-Semenowicz, Monika, Ratajczyk, Joanna, Wolska, Lidia, Rutkowski, Przemysław, Jankowska, Magdalena, Rutkowski, Bolesław, Dębska- Ślizień, Alicja
• Format: Article
• Language: English
• Subjects: Aged; Albumin; Amino acids; Amino Acids - blood; Body fat; Body mass index; Body size; Body weight; C-reactive protein; Calories; Carbohydrates; Cholesterol; Cluster analysis; Dietary Supplements; Enzyme-linked immunosorbent assay; Female; Hemodialysis; High performance liquid chromatography; Humans; Interleukin 6; Kidney Failure, Chronic - therapy; Lean body mass; Liquid chromatography; Male; Malnutrition; Middle Aged; Nutrients - therapeutic use; Nutrition Assessment; Nutritional Status; oral supplements; Patients; Prealbumin - metabolism; Protein synthesis; Protein-Energy Malnutrition - complications; Protein-Energy Malnutrition - drug therapy; Proteins; Renal Dialysis - adverse effects; Serum albumin; Serum Albumin - metabolism; Trace elements; Tumor necrosis factor-TNF; Wasting Syndrome - drug therapy; Wasting Syndrome - etiology
• ISSN: 0899-9007; 1873-1244
• DOI: 10.1016/j.nut.2018.06.013

•The amino acid needs of patients on hemodialysis are largely undetermined.•We provide the benefits of oral supplementation in protein-energy wasting in this patient population.•Attention to this area is needed.•We provide thorough background for future research. Protein-energy wasting (PEW) is highly prevalent in patients on hemodialysis (HD). Oral nutritional supplementation (ONS) is recommended for malnourished patients on HD. The aim of this study was to evaluate ONS on plasma amino acid in HD patients with PEW. Thirty-two HD patients with a mean age 59.1 ± 9.5 y with PEW were enrolled into the study. Patients were prescribed ONS (125 mL twice a day for 3 mo) together with dietary advice. The nutritional status was evaluated by means of body mass index, Subjective Global Assessment, and serum albumin and prealbumin levels. The percentages of body fat and lean body mass were measured by means of the near-infrared method. The lean body mass-to-body weight ratios were calculated. Tumor necrosis factor, interleukin-6 and high-sensitivity C-reactive protein, were measured by the enzyme-linked immunosorbent assay method. Serum concentrations of amino acids were measured by the high-performance liquid chromatography method. After 3 mo of ONS, a significant increase of both serum prealbumin and albumin was observed. The concentration of most of the amino acids increased independently on inflammation. Conclusions: Dietary advice, combined with ONS, is effective in HD patients with PEW. Both dietary advice and ONS are needed to be sure that patients consume an adequate daily amount of calories and protein.