Frequency of Intradialytic Hypotension Events Do Not Increase with Oral Nutritional Supplementation during Hemodialysis Treatment: A Randomized Controlled Trial

Ramos-Acevedo, Samuel; González-Ortiz, Ailema; Serralde‐Zúñiga, Aurora E.; Colin-Ramírez, Eloisa; Miranda-Alatriste, Paola; López-Cisneros, Sonia; Rodríguez-González, Norberto; Correa‐Rotter, Ricardo; Atilano-Carsi, Ximena; Espinosa-Cuevas, Ángeles

doi:10.1053/j.jrn.2020.10.002

Cited by 4 publications

(3 citation statements)

References 24 publications

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“…In relation to weight gain and nutritional status, the ONS group significantly increased body weight but no statistically significant improvements in the MIS score were observed. Similar to these findings, Ramos-Acevedo et al [ 43 ] recently reported that after three months of intervention with intradialytic ONS, the dry weight improved significantly and contrary to our findings, in this study MIS score improved significantly.…”

Section: Discussionsupporting

confidence: 62%

Effect of Intradialytic Oral Nutritional Supplementation with or without Exercise Improves Muscle Mass Quality and Physical Function in Hemodialysis Patients: A Pilot Study

et al. 2022

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Background: Oral nutritional supplementation (ONS) with or without exercise (EX) could improve muscle mass (MM) in chronic kidney disease. Methods: Patients were randomized into two groups: (1) ONS and (2) ONS + EX. Thigh muscle area (cm2) and intramuscular lipid content via attenuation were evaluated at baseline and 6 months with computed tomography (CT) to measure MM quantity and quality. Physical function was measured by six-minute walk test (6 MWT), gait speed, handgrip strength (HGS), and Time Up and Go test (TUG) at baseline and 3 and 6 months. Results: The ONS group (n= 14) showed statistically significant improvement in gait speed and HGS; ONS + EX group (n = 10) showed differences in gait speed, in 6 MWT, and HGS. In the ANOVA (3 times × 2 groups), no differences were observed between groups. Greater effect sizes in favor to ONS + EX group were observed in the 6 MWT (d = 1.02) and TUG test (d = 0.63). Muscle quality at six months revealed a significant trend in favor of the EX-group (p = 0.054). Conclusions: Both groups had improved physical function, and greater effect sizes were seen in the ONS + EX group for the 6 MWT and TUG test. Neither MM quantity or quality was improved in either group.

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Section: Discussionsupporting

confidence: 62%

Effect of Intradialytic Oral Nutritional Supplementation with or without Exercise Improves Muscle Mass Quality and Physical Function in Hemodialysis Patients: A Pilot Study

et al. 2022

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“…There is a large body of evidence that states that oral supplementation decreases hospital admission rates, serum IL-6 levels (34), improves hypoalbuminemia (35), physical functionality (36), PEW (37), better body composition markers (38), quality of life (39), and reduces mortality (40). However, the evidence of ION compared with nutrition at home is scarce, although this strategy has already been shown to be safe and effective, as recently demonstrated by Ramos-Acevedo et al (41).…”

Section: Discussionmentioning

confidence: 99%

Sleep Quality After Intradialytic Oral Nutrition: A New Benefit of This Anabolic Strategy? A Pilot Study

et al. 2022

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BackgroundSince disturbances of appetite and sleep are closely related and both affect metabolic disorders, it would be expected that a renal specific oral nutritional supplement (RS-ONS) that covers the energy the patient does not consume on the HD day, could contribute to improve the nutritional status and body composition, as well as sleep quality. There is still scarce information related to this topic.AimTo evaluate the effect of the use of intra-dialytic RS-ONS vs. RS-ONS at home on sleep quality, nutritional status, and body composition in patients on HD.MethodsAdult patients < 65 years, with ≥3 months on HD were invited to participate in an open randomized pilot study (ISRCTN 33897). Patients were randomized to a dialysis-specific high-protein supplement provided during the HD session (Intradialytic oral nutrition [ION]) or at home (control), during non-HD days (thrice weekly, for both) 12 weeks. The primary outcome was sleep quality defined by the Pittsburgh Sleep Quality Index (PSQI) score. Nutritional assessment included Malnutrition Inflammation Score (MIS), bioelectrical impedance analysis, anthropometry, 3-day food records, and routine blood chemistries.ResultsA total of 23 patients completed the study. Age was median 35 (range 24–48 years), 42% were women. At baseline, the PSQI score was median 4 (range 2–7), and MIS showed a median of 6 (range 5–8); there were no baseline differences between groups. After intervention, both groups improved their MIS scores and similarly when we analyzed the whole cohort (pre- vs. post-intervention P < 0.01). Patients in the ION group improved the overall PSQI score to median 3 (2–5), and assessment of sleep duration and sleep disturbances (pre- vs. post-intervention P < 0.05), with a trend toward an effect difference compared to patients consuming the supplement at home (P for treatment-effect across arms 0.07 for PSQI score and 0.05 for sleep latency).ConclusionOral supplementation improved nutritional status in the whole cohort, but only ION improved the PSQI score. More studies are needed to explore the nutritional strategies that influence the relationship between sleep and nutritional status in HD patients.

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“…In the randomized controlled trial by Ramos-Acevedo et al, 38 intradialytic hypotension events did not increase with the oral nutritional supplement during 1,082 hemodi-alysis sessions that were closely observed. Hence, eating during hemodialysis that has been cautiously recommended by the ISRNM as an important patient-centered strategy, 39 appears to be a safe anabolic nutritional strategy for the prevention of protein-energy wasting.…”

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confidence: 83%

The World Kidney Recipes: Teaming up to Empower Patients, Care-Partners, Dietitians, and Chefs With Culinary Creativity and Multicultural Diversity in Renal Nutrition and Dietetics

Kalantar-Zadeh

Wang

Moore

et al. 2021

Journal of Renal Nutrition

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Frequency of Intradialytic Hypotension Events Do Not Increase with Oral Nutritional Supplementation during Hemodialysis Treatment: A Randomized Controlled Trial

Cited by 4 publications

References 24 publications

Effect of Intradialytic Oral Nutritional Supplementation with or without Exercise Improves Muscle Mass Quality and Physical Function in Hemodialysis Patients: A Pilot Study

Effect of Intradialytic Oral Nutritional Supplementation with or without Exercise Improves Muscle Mass Quality and Physical Function in Hemodialysis Patients: A Pilot Study

Sleep Quality After Intradialytic Oral Nutrition: A New Benefit of This Anabolic Strategy? A Pilot Study

The World Kidney Recipes: Teaming up to Empower Patients, Care-Partners, Dietitians, and Chefs With Culinary Creativity and Multicultural Diversity in Renal Nutrition and Dietetics

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