BackgroundProtein-energy malnutrition is a common problem in hemodialysis patients and has different outcomes such as reduced quality of life, longer hospitalization time, lower dialysis adequacy, and higher mortality rate. Investigation of dialysis adequacy is an important method for assessing hemodialysis patients, and improving the dialysis adequacy is an important healthcare team goal.ObjectivesThe present study aims to investigate and compare the effects of BCAA and ISO-WHEY oral nutritional supplements on dialysis adequacy.MethodsIn a clinical trial study, 66 hemodialysis patients were randomly divided into three groups: Group A (n = 22), Group B (n = 22), and Group C or the control group (n = 22). In Groups A and B, as prescribed and controlled by nutritionists and nephrologists, respectively, ISO-WHEY and BCAA protein powder were used for 2 months on a daily basis. For all groups, before intervention and 1 and 2 months after intervention, the dialysis adequacy was measured using URR and Kt/V. Finally, the data were analyzed using IBM SPSS Statistics Base 21.0 software.ResultsOut of 66 patients, 61 (19 in Group A, 20 in Group B, and 22 in Group C) completed the study period, and before intervention, all groups were equal in terms of quality and quantity variables (P > 0.05). After intervention, there was a significant difference between the three groups with regard to the variables of dialysis adequacy based on Kt/V and URR to independent-t test and repeated measures ANOVA (P < 0.05).ConclusionsResults show that the intake of oral nutritional supplements leads to an improvement in the dialysis adequacy of hemodialysis patients. Therefore, the use of nutritional supplements along with patients' training and regular consultation will be helpful in improving the nutritional status, dialysis adequacy, and eventually the quality of life.

Background: Muscle wasting and protein malnutrition is a common problem in hemodialysis patients and has different complications such as a reduced quality of life, longer hospital stays, and higher mortality rates. The aim of this study was to evaluate the effect of 8 weeks of intradialytic isometric training on muscle capacity and serum albumin levels in hemodialysis (HD) patients. Methods: In a clinical trial, 34 patients were randomly allocated into 2 groups: exercise group (EX) (n = 17) and control group (n = 17). The training program was conducted twice a week for 2 months (24 sessions). Forearm endurance, leg raise endurance, and grip strength were measured for muscle capacity aspect and serum albumin levels, which were evaluated before and post-intervention. Results: There was no significant difference between the groups in terms of demographic variables (P and gt; 0.05). After the intervention, the muscle capacity variable presented a significant difference between the exercise group and the control group (P and lt; 0.001). As for the albumin levels, there was no significant difference between the 2 groups. Conclusions: The results showed that exercise during hemodialysis could increase muscle capacity and could be helpful for maintaining the albumin levels in hemodialysis patients.

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Background:The effectiveness of dialysis or dialysis adequacy is an important standard for evaluating hemodialysis patients. Also, measuring this standard is a crucial goal to all healthcare teams. Inadequate protein intake and catabolism can impact dialysis efficacy.Objectives: This study aimed to investigate the effect of intradialytic isometric resistance exercise and supplementation with BCAAs on dialysis adequacy in patients undergoing dialysis.Methods: A total of 51 patients were randomly divided into three control, exercise and BCAA (EXBCAA), and exercise only (EX) groups and the number of the subjects in each group was 17 patients. The training program consisted of an exercise for arm muscles and another exercise for thigh and core muscles. Exercise sessions were conducted twice a week for two months (24 sessions). Dialysis adequacy variables were kt/v and URR and were measured before the intervention, four weeks after the start of the intervention, and again at eight weeks, which was the end point of the intervention.Results: After the intervention, the kt/V and URR variables presented a significant difference between the two experimental groups vs the control group (P < 0.001). The group that received BCAA and performed isometric resistance exercise indicated the most effective improvements in kt/v (+20%) and URR (+12.5%). Conclusions:Results of this study showed that exercise during hemodialysis can increase dialysis adequacy of hemodialysis patients. Receiving BCAA's can improve the adequacy even more.