Nutrition counseling impacts serum albumin levels☆

Abstract 

Objective

To determine the difference in the rate of change of serum albumin levels between protein-energy malnourished patients who receive intensive dietary counseling and patients who receive a special oral liquid nutritional supplement (Nepro; Ross Products, Division Abbott Laboratories, Columbus, OH).

Design

Participants with serum albumin values ≤3.5 g/dL (bromocresol green) or 3.2 g/dL (bromocresol purple) and a Mini Nutrition Assessment (MNA) Malnutrition score ≤23.5 were randomized to the supplement group (Nepro) or the nonsupplement group with intensive dietary counseling.

Patients

Forty-one hemodialysis patients 18 years and older who had been on dialysis for at least 6 months.

Intervention

Participants were randomly assigned to supplement (26) or nonsupplement (14) groups.

Main outcome measures

Albumin levels.

Statistical analyses performed

Analysis of variance and χ² tests, linear regression.

Results

After adjustment for demographic and clinical characteristics, the rate of change in serum albumin level was significantly greater among patients randomized to dietary counseling alone than among those who received oral supplements. These preliminary results suggest that intensive nutritional counseling may be of greater benefit than nutritional supplements alone in the management of protein-energy malnutrition in patients on hemodialysis. These preliminary findings should be confirmed by a larger full-scale trial.