A Low-Cost, Intradialytic, Protein-Rich Meal Improves the Nutritional Status in Chinese Hemodialysis Patients

Abstract

Short-term administration of oral nutritional supplements can improve the nutritional status of hemodialysis patients. However, such treatment is associated with high cost. The aim of the present trial was to evaluate the benefits of the short-term administration of a low-cost, intradialytic, protein-rich meal on selected parameters of the nutritional status in Chinese patients undergoing hemodialysis. This was a 6-month single-center, prospective interventional study. Stable hemodialysis patients aged ≥18 years with a concentration of serum albumin <40 g/L were eligible for inclusion in this study. Patients allocated to the intervention group (IG) received nutritional counseling plus a low-cost, intradialytic, protein-rich meal thrice weekly over a period of 3 months, followed by a treatment-free period of 3 months. Patients allocated to the control group (CG) received nutritional counseling alone. Changes in serum albumin and body composition were investigated. At the start of the study, both groups were similar except for the levels of C-reactive protein (P = .034) and hemoglobin (P=.003). At the end of the study period, the level of serum albumin (P = .001) was significantly increased with increased protein intake in the IG (P = .048). However, this difference was not sustained during the follow-up period after termination of therapy. In the IG, the levels of serum albumin were significantly decreased between months 3 and 6 (P < .001), whereas those in the CG remained unchanged. There were no statistically significant differences observed between the two groups in the levels of C-reactive protein and body composition. The short-term administration of a low-cost, intradialytic, protein-rich meal (i.e., 200 mL milk plus two egg whites) resulted in a significant improvement in the levels of serum albumin versus nutritional counseling alone. This inexpensive nutritional intervention was feasible for the treatment of Chinese patients undergoing hemodialysis.