Effects of Peridialytic Oral Supplements on Nutritional Status and Quality of Life in Chronic Hemodialysis Patients

Scott, Meri Kay; Shah, Niyati A.; Vilay, A. Mary; Thomas, Joseph; Kraus, Michael A.; Mueller, Bruce A.

doi:10.1053/j.jrn.2008.08.004

« Previous Next »Journal of Renal Nutrition
Volume 19, Issue 2 , Pages 145-152, March 2009

Effects of Peridialytic Oral Supplements on Nutritional Status and Quality of Life in Chronic Hemodialysis Patients

Meri Kay Scott, PhD
- Clinical Development Organization, Eli Lilly and Co., Indianapolis, Indiana
Niyati A. Shah, MS
- MBA Candidate, Columbia Business School, Columbia University, New York, New York
A. Mary Vilay, PharmD
- Department of Clinical, Social, and Administrative Sciences, College of Pharmacy, University of Michigan, Ann Arbor, Michigan
Joseph Thomas III, PhD
- Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Purdue University, West Lafayette, Indiana
Michael A. Kraus, MD
- Division of Nephrology, Department of Medicine, School of Medicine, Indiana University, Indianapolis, Indiana
Bruce A. Mueller, PharmD, FCCP
- Department of Clinical, Social, and Administrative Sciences, College of Pharmacy, University of Michigan, Ann Arbor, Michigan
- Address reprint requests to Bruce A. Mueller, PharmD, FCCP, Department of Clinical, Social, and Administrative Sciences, College of Pharmacy, University of Michigan, 428 Church St., Ann Arbor, MI 48109-1065.

Objective

Our objective was to determine the effects of peridialytic oral supplements on nutritional markers and quality of life (QOL) in patients receiving maintenance hemodialysis.

Design

This trial was open, prospective, nonrandomized, and comparative.

Setting

This study was performed at an outpatient hemodialysis unit in a teaching hospital.

Patients

This study included 88 adults with chronic kidney disease at stage 5.

Intervention

This study involved directly observed nutrition therapy with ≥1 can of enteral nutrition (Nepro) with each hemodialysis session thrice weekly for 3 months, or standard care.

Main Outcome Measure

Changes in biochemical markers of nutritional status and QOL, as measured by the Kidney Disease Quality of Life-Short Form, were determined.

Results

Peridialytic oral nutrition resulted in a significant difference between the nutrition and comparison groups in serum albumin change over time (P = .03; repeated-measures analysis of variance with covariates). Mean (±SD) serum albumin concentration did not differ between baseline and month 3 in the nutrition group (3.68 ± 0.33 g/dL vs. 3.75 ± 0.40 g/dL; P = .12), but in the comparison group, serum albumin levels declined significantly (3.93 ± 0.34 g/dL at baseline versus 3.81 ± 0.37 g/dL at month 3; P = .04). The “role-physical” domain score of the Kidney Disease Quality of Life-Short Form significantly changed over time in the nutrition group versus the comparison group (P = .02; repeated-measures analysis of variance with covariates). Nepro was well-tolerated, and greater than 80% of the prescribed therapy was consumed.

Conclusion

Oral nutrition, as part of structured, directly observed peridialytic therapy in chronic hemodialysis patients, was well-accepted, and resulted in the maintenance of serum albumin levels and QOL with respect to impact of physical health on daily activities. These findings need to be confirmed in a randomized, controlled trial.