Journal of Renal Nutrition
Volume 19, Issue 5 , Pages 412-421 , September 2009

Oral Protein Supplementation Alone Improves Anabolism in a Dose-Dependent Manner in Chronic Hemodialysis Patients

  • Mary B. Sundell, RD

      Affiliations

    • Division of Nephrology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
    • ,
  • Kerri L. Cavanaugh, MD, MHS

      Affiliations

    • Division of Nephrology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
    • ,
  • Pingsheng Wu, PhD, MS

      Affiliations

    • Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
    • ,
  • Ayumi Shintani, PhD, MPH

      Affiliations

    • Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
    • ,
  • Raymond M. Hakim, MD, PhD

      Affiliations

    • Division of Nephrology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
    • Fresenius Medical Care of North America, Waltham, Massachusetts
    • ,
  • T. Alp Ikizler, MD

      Affiliations

    • Division of Nephrology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
    • Corresponding Author InformationAddress reprint requests to T. Alp Ikizler, MD, Division of Nephrology, Department of Medicine, Vanderbilt University Medical Center, 1161 21st Ave. South and Garland, S-3223 MCN, Nashville, TN 37232-2372.

References 

  1. Ikizler TA, Hakim RM. Nutrition in end-stage renal disease. Kidney Int. 1996;50:343–357
  2. Kopple JD. Effect of nutrition on morbidity and mortality in maintenance dialysis patients. Am J Kidney Dis. 1994;24:1002–1009
  3. Pupim LB, Flakoll PJ, Brouillette JR, et al. Intradialytic parenteral nutrition improves protein and energy homeostasis in chronic hemodialysis patients. J Clin Invest. 2002;110:483–492
  4. Pupim LB, Majchrzak KM, Flakoll PJ, Ikizler TA. Intradialytic oral nutrition improves protein homeostasis in chronic hemodialysis patients with deranged nutritional status. J Am Soc Nephrol. 2006;17:3149–3157
  5. Cano NJ, Fouque D, Roth H, et al. Intradialytic parenteral nutrition does not improve survival in malnourished hemodialysis patients: a 2-year multicenter, prospective, randomized study. J Am Soc Nephrol. 2007;18:2583–2591
  6. Wolfe RR. Protein supplements and exercise. Am J Clin Nutr. 2000;72(Suppl):551S–557S
  7. Ikizler TA, Pupim LB, Brouillette JR, et al. Hemodialysis stimulates muscle and whole body protein loss and alters substrate oxidation. Am J Physiol Endocrinol Metab. 2002;282:E107–E116
  8. Pupim LB, Flakoll PJ, Brouillette JR, et al. Intradialytic parenteral nutrition improves protein and energy homeostasis in chronic hemodialysis patients. J Clin Invest. 2002;110:483–492
  9. Wolfe R. Radioactive and stable isotope tracers in biomedicine: principles and practice of kinetic analysis. New York: Wiley-Liss; 1992;pp 283-316
  10. Ikizler TA, Pupim RB, Brouillette JR, et al. Hemodialysis stimulates muscle and whole-body protein loss and alters substrate oxidation. Am J Physiol Endocrinol Metab. 2002;282:E107–E116
  11. Kobayashi H, Borsheim E, Anthony TG, et al. Reduced amino acid availability inhibits muscle protein synthesis and decreases activity of initiation factor eIF2B. Am J Physiol Endocrinol Metab. 2003;284:E488–E498
  12. Flakoll PJ, Carlson M, Cherrington AC. Physiological action of insulin. In:  Leroith DTS,  Olefsky J editor. Diabetes mellitus: a fundamental and clinical text. 2nd ed. Philadelpia: Williams & Wilkins; 2000;p. 148–161
  13. Stratton RJ, Bircher G, Fouque D, et al. Multinutrient oral supplements and tube feeding in maintenance dialysis: a systematic review and meta-analysis. Am J Kidney Dis. 2005;46:387–405

 This study was supported in part by National Institutes of Health grants R01-DK45604 and K24-DK62849, by Diabetes Research Training Center Grant DK-20593 from the National Institute of Diabetes, Digestive and Kidney Diseases, by grant UL1 RR024975 from the National Center for Research Resources, and by an unrestricted grant from Medical Nutrition USA, Inc. M.B.S. is supported in part by a grant from the National Kidney Foundation Council of Renal Nutrition. K.L.C. is supported by grant K23 K23-DK080952 from the National Institute of Diabetes, Digestive and Kidney Diseases.

 The authors declare no conflict of interest with regard to involvement with the commercial entities that supplied nutritional supplements.

PII: S1051-2276(09)00041-7

doi: 10.1053/j.jrn.2009.01.019

Journal of Renal Nutrition
Volume 19, Issue 5 , Pages 412-421 , September 2009

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