Effect of an intradialytic protein-rich meal intake in nutritional and body composition parameters on hemodialysis patients

Caetano, Cristina; Valente, Ana Paula; Silva, Francisco Jorge; Antunes, Jorge; Garagarza, Cristina

doi:10.1016/j.clnesp.2017.04.003

Cited by 20 publications

(24 citation statements)

References 11 publications

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“…Moreover, in order to avoid flavor monotony; varying the types of herbs and spices, such as oregano, rosemary, dill, tarragon, cumin, garlic, paprika and onion, among others, can be used without compromising the energy, protein, Na, K and P content of the muffins. Other studies that developed non-industrialized food products for HD, although scarce, showed promising results in improving the nutritional status of patients that were malnourished [31][32][33][34].…”

Section: Discussionmentioning

confidence: 99%

Development of muffins as dialysis snacks for patients undergoing hemodialysis: results of chemical composition and sensory analysis

et al. 2020

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Objective This study aimed to develop two non-industrial food products as financially accessible options to prevent and treat malnutrition in hemodialysis (HD) patients. These food products were developed and intended for use as dialysis snacks. Methods This is a cross-sectional and multi-step study. First, 183 adult HD patients (55 ± 14 years; 50.8% males), replied to a questionnaire with their food preferences regarding taste (salty, sweet, bitter, sour) and consistency (liquid, solid, pasty) for a dialysis snack. Most patients preferred a food product with a solid consistency (90%) and a salty flavor (81.4%). Second, three muffin formulations of fine herbs were developed; one enriched with whey protein concentrate (WPC), a second with textured soy protein (TSP) and a third standard formulation without protein for comparison with the protein-enriched muffins, for which the chemical and nutritional compositions were analyzed. In the third step, 60 patients on HD (61 ± 15 years; 53% males) were enrolled in a sensory analysis by applying a 9-point structured hedonic scale, ranging from "extremely liked" (score 9) to "extremely disliked" (score 1). Results When compared with the standard formulation, the formulations enriched with WPC and TSP protein had a significantly higher amount of protein/serving (Standard: 5.9 ± 0.3 g vs WPC: 14.5 ± 0.9 g and TSP 10.8 ± 0.7 g; P < 0.05) but a lower amount of carbohydrate (Standard: 13.1 ± 2.2 g vs WPC: 5.6 ± 0.8 g and TSP 6.0 ± 1.2 g vs; P < 0.05). The mineral content/serving of the protein-enriched muffins was low in phosphorus (50 mg) and sodium (180 mg). The potassium content/ serving was moderate for the WPC muffin (225.2 mg) and low for the TSP muffin (107.9 mg). The acceptability index (AI) for the enriched protein muffins was higher than 70% and similar to the standard formulation. Conclusion The muffins with fine herbs and enriched with protein were well-accepted by all patients and appropriate to serve as dialysis snacks for HD patients.

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Section: Discussionmentioning

confidence: 99%

Development of muffins as dialysis snacks for patients undergoing hemodialysis: results of chemical composition and sensory analysis

et al. 2020

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“…We found differences between the answers of specific HCP groups. Given the above and the fact that different studies have shown that patients in HD do not meet their energy and protein needs 6,7 , ION might be a useful strategy to implement 26,27 .…”

Section: Discussionmentioning

confidence: 99%

“…Kistler et al 25 mentioned that the most important concern, for both experienced and inexperienced HCP about oral supplementation during HD sessions, is intradialytic hypotension, although it rarely occurs in people who consume food during the session [26][27][28][29] . The concern that patients may develop intradialytic hypotension related to the consumption of food or supplements during an HD session is based on a theoretical-physiological notion involving hemodynamic redistribution, given that blood perfusion is concentrated in the digestive system, and a considerable volume of it circulates through the HD system.…”

Section: Discussionmentioning

confidence: 99%

Survey on the Perception of Health Professionals on the Use of Intradialytic Oral Nutrition in Patients under Hemodialysis

Ramos-Acevedo

González-Ortiz

Correa‐Rotter

et al. 2020

RIC

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Background: Intradialytic oral nutrition (ION) has been shown to improve many clinical outcomes, including lowering mortality, in hemodialysis (HD) patients. Despite the benefits, ION is underused in many countries. Objective: The objective of our study was to determine the perception of health-care professionals (HCP) in our environment of the use of ION in patients undergoing HD. Methods: Survey applied to HCP in Mexico who worked or had worked in an HD unit in their locality. Results: From 272 HCP who answered the survey, 74.3% believed that the use of ION has at least one beneficial effect; of these, the most frequently mentioned were an improvement in quality of life (QoL) (54.7%) followed by an improvement in serum albumin (37.9%) and muscle anabolism (31.6%). However, 49% consider that its use involves some risks. Of the respondents, 22% reported that their HD units allowed patients to consume food or supplements during HD sessions; the main reason given to forbid the introduction of food or supplements was the clinic's policy (41%). Conclusions: The personnel surveyed heterogeneous opinions regarding ION, but most believe that it may improve the QoL or the nutritional status of the patients. Nevertheless, the use of ION is uncommon in our country as it is against the internal regulations of most HD units.

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“…In a nonrandomized study in which patients with a serum albumin level below 38 g/L received a high protein meal during dialysis, their FTI increased in contrast to a decline in FTI in the control group. However, LTI decreased both in the interventional and in the control groups . In addition, the PESET study used 3C BIS to monitor changes in body composition assigned to HD or OL‐HDF and observed a decline in LTM and an increase in ATM in HD as compared to the OL‐HDF patients .…”

Section: Interventional Studies Using 3c Bismentioning

confidence: 99%

Three compartment bioimpedance spectroscopy in the nutritional assessment and the outcome of patients with advanced or end stage kidney disease: What have we learned so far?

Broers

Canaud

Dekker

et al. 2020

Hemodialysis International

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Bioimpedance spectroscopy (BIS) is an easily applicable tool to assess body composition. The three compartment model BIS (3C BIS) conventionally expresses body composition as lean tissue index (LTI) (lean tissue mass [LTM]/height in meters squared) and fat tissue index (FTI) (adipose tissue mass/ height in meters squared), and a virtual compartment reflecting fluid overload (FO). It has been studied extensively in relation to diagnosis and treatment guidance of fluid status disorders in patients with advanced-stage or end-stage renal disease. It is the aim of this article to provide a narrative review on the relevance of 3C BIS in the nutritional assessment in this population. At a population level, LTI decreases after the start of hemodialysis, whereas FTI increases. LTI below the 10th percentile is a consistent predictor of outcome whereas a low FTI is predominantly associated with outcome when combined with a low LTI. Recent research also showed the connection between low LTI, inflammation, and FO, which are cumulatively associated with an increased mortality risk. However, studies toward nutritional interventions based on BIS data are still lacking in this population. In conclusion, 3C BIS, by disentangling the components of body mass index, has contributed to our understanding of the relevance of abnormalities in different body compartments in chronic kidney disease patients, and appears to be a valuable prognostic tool, at least at a population level. Studies assessing the effect of BIS guided nutritional intervention could further support its use in the daily clinical care for renal patients.

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Effect of an intradialytic protein-rich meal intake in nutritional and body composition parameters on hemodialysis patients

Cited by 20 publications

References 11 publications

Development of muffins as dialysis snacks for patients undergoing hemodialysis: results of chemical composition and sensory analysis

Development of muffins as dialysis snacks for patients undergoing hemodialysis: results of chemical composition and sensory analysis

Survey on the Perception of Health Professionals on the Use of Intradialytic Oral Nutrition in Patients under Hemodialysis

Three compartment bioimpedance spectroscopy in the nutritional assessment and the outcome of patients with advanced or end stage kidney disease: What have we learned so far?

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