Evaluation of Proteolytic Enzyme on Hemodialysis Patients with Protein–Energy Wasting and Associated Variables

Abstract

Introduction: Protein–energy wasting (PEW) is very commonly seen among hemodialysis (HD) patients. This study was carried out to estimate the nutrition status of HD patients receiving aminase tablets, a proteolytic enzyme with a high-protein diet, for reducing PEW. Methods and Materials: The outpatients who visited the HD unit were nutritionally assessed using the Subjective Global Assessment (SGA). Malnourished patients were selected for the study. Diet advice was given on a high-protein diet as per the standard renal guidelines. They were nutritionally assessed pre- and postsupplementation at 0–6 months gap using SGA, malnutrition-inflammation score (MIS), bioelectrical impedance analysis, hand grip dynamometer, C-reactive protein (CRP), serum albumin, and total iron-binding capacity. Patients were given proteolytic enzyme 2 capsules daily after food (morning and night) for 6 months and high-protein diet. Results: A significant improvement (P < 0.05) was seen in the intracellular water, body cell mass, skeletal muscle mass, and protein mass. An improvement in the mean hand grip strength and mean reduction of CRP, SGA, and MIS scores were observed. Conclusion: Proteolytic enzyme along with a high-protein diet could be recommended for better clinical outcomes in dialysis patients.