The effect of protein-enriched snacks on serum albumin concentration in non-selected haemodialysis patients.

Abstract

Serum albumin level is not only one of the protein-energy wasting criteria but also a powerful marker of mortality in patients on haemodialysis (HD) treatment. The study aimed to assess the effect of a protein-enriched snack given during HD treatment on serum albumin level. This prospective, single-centre, observational, non-randomized 16-month study was sub-divided into four 4-month periods.Patients on hemodialysis for more than three months and receiving a regular standard snack (8.8g of protein) during the HD session were included and assigned during four four-month periods to receive either the standard snack or a protein-enriched snack (28.7g). Patients were not selected based on nutritional criteria. Sixty-sixpatients completed the study. Serum albumin levels significantly increased, from 3.43 ± 0.28g/dl in the first period (standard snack) to 3.62 ± 0.32g/dl (p < 0.0001) in the second period (enriched snack). In the third period (standard snack), albumin levels remained stable (3.61 ± 0.35g/dl). After the fourth period (enriched snack), serum albumin levels further increased significantly(3.69 ± 0.30 g/dl;p = 0.05 and p = 0.007, respectively). Weight and normalized protein nitrogen appearance remained stable during the 16-month study period. This study suggests that the intake of a protein-enriched snack during HD treatment, independently from baselineserum albumin level, could significantly increase their serum albumin levels. Serum albumin level is a powerful predictor of mortality; therefore, this simple and effective action could be of real interest to improve patients' outcomes.