Randomized double-blind trial of oral essential amino acids for dialysis-associated hypoalbuminemia

Eustace, Joseph A.; Coresh, Josef; Kutchey, Chris; Te, Purita L.; Gimenez, Luis F.; Scheel, Paul J.; Walser, Mackenzie

doi:10.1046/j.1523-1755.2000.00112.x

Cited by 118 publications

(74 citation statements)

References 38 publications

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“…For instance, Eustace et al reported that essential amino acids (EAAs) failed to produce a significant improvement in the serum albumin concentration in PD patients [55]. In our study, we observed that the group treated with oral AA preparations had lower post-study albumin and HbA1c levels than those recorded at baseline.…”

Section: Discussionsupporting

confidence: 44%

Comparison of Intraperitoneal Amino Acid and Oral Amino Acid Supplements in Peritoneal Dialysis Patients

Sarıkaya¹,

Bora²,

İnci³

et al. 2014

J Nephrol Ther

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Section: Discussionsupporting

confidence: 44%

Comparison of Intraperitoneal Amino Acid and Oral Amino Acid Supplements in Peritoneal Dialysis Patients

Sarıkaya¹,

Bora²,

İnci³

et al. 2014

J Nephrol Ther

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“…One study documented that serum albumin rose from 2.6±0.4 to 3.1±0.7 g/dL after 6 months of oral nutritional supplement. 17 However, in this study and other related studies, 21,22 no significant changes were observed in serum albumin concentration after intervention. The explanation for the negative finding was probably that at the end of follow-up, the subjects of this study continued to show significantly lower nutritional intake than recommended, and only a short-term nutritional supplement for 15 days was provided.…”

contrasting

confidence: 48%

Nutritional status among peritoneal dialysis patients after oral supplement with ONCE dialyze formula

Satirapoj¹,

Limwannata²,

Kleebchaiyaphum³

et al. 2017

IJNRD

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Background:Malnutrition is an important problem in patients treated with long-term dialysis, and most dialysis patients have lower dietary energy and protein intake. This study was undertaken to examine whether orally administered Otsuka Nutrition Pharmaceutical (ONCE) dialyze formula (ODF) supplement would improve energy intake without mineral and electrolyte disturbances in patients with continuous ambulatory peritoneal dialysis (CAPD). Methods:The effects of ODF supplementation on nutrition markers including serum albumin and prealbumin concentrations and inflammatory stress in patients with chronic CAPD were evaluated. All patients received daily oral ODF supplements for 15 days. During follow-up, all patients were evaluated clinically and biochemically, and nutritional status was assessed. Results: Thirty patients with mean age 61.9±12.3 years and weekly Kt/V 2.2±0.4 were studied. The mean values for nutritional parameters included a body weight of 53.7±9.5 kg, a serum albumin level of 3.3±0.4 g/dL, a serum prealbumin level of 33.8±11.1 mg/dL, a dietary energy intake of 21.9±7.1 kcal/kg/day, and a dietary protein intake of 0.9±0.3 g/kg/day. After 15-day ODF treatment, these patients had significant dietary energy and protein, carbohydrate, fat, fiber, potassium, calcium, and magnesium intake from baseline (P<0.05). Furthermore, significant improvements were found in nutritional markers including body weight, blood urea nitrogen, and prealbumin levels, but no changes were observed in serum albumin and high-sensitivity C-reactive protein levels. At the end of follow-up, the frequency of patients with moderate malnutrition decreased from 24.2% to 18.2%, and no increased incidence was observed of hyperkalemia, hyperphosphatemia, and metabolic acidosis. Conclusion: ODF supplementation ameliorates low dietary energy and nutrient intake as well as improves serum prealbumin and body weight in patients with long-term CAPD.

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“…Several small-scale, short-term studies, including a few controlled trials, indicate that oral nutritional supplementation administration can be an effective approach to preventing deranged nutritional status (15)(16)(17). In addition, a few studies indicated benefits of PO given during HD to treat the HDassociated protein catabolism (4,18).…”

Section: Discussionmentioning

confidence: 99%

Intradialytic Oral Nutrition Improves Protein Homeostasis in Chronic Hemodialysis Patients with Deranged Nutritional Status

Pupim

Majchrzak

Flakoll³

et al. 2006

Journal of the American Society of Nephrology

141

107

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. Among the many different causes that are associated with altered nutritional status in ESRD, the hemodialysis (HD) procedure has been associated clearly with net whole-body (WB) protein and skeletal muscle (SM) protein loss (3). This catabolic process can be reversed acutely by administration of intradialytic parenteral nutrition (IDPN) (4). Despite its shown anabolic effects, IDPN administration is costly, and patient eligibility for this type of nutrition support is widely restricted. In addition, the anabolic effects of IDPN seem to be limited to the period of administration, with no evidence of persistent anabolism once its infusion is shut off (4).Oral nutritional supplementation (PO) is a promising anabolic intervention in chronic HD (CHD) patients because of its potentially more physiologic and affordable characteristics. Despite its potential benefits, only limited studies have evaluated the effects of intradialytic PO administration on protein metabolism in CHD patients, and none to our knowledge has compared its metabolic effects with those of IDPN in CHD patients with deranged nutritional status.In this study, we hypothesized that administration of intradialytic PO supplementation would compensate WB and SM protein derangements as a result of the HD procedure, resulting in net protein anabolism. We further hypothesized that these beneficial effects would be less than what is observed with IDPN administration. To test these hypotheses, we studied protein metabolism in eight CHD patients with deranged nutritional status during three separate HD sessions-with PO, with IDPN, and with no intervention (control)-using stable isotope infusion techniques. Materials and Methods PatientsPatients were recruited from the Vanderbilt University Outpatient Dialysis Unit. Inclusion criteria consisted of patients who were on CHD for Ͼ6 mo, were using a biocompatible HD membrane (Fresenius F80; Fresenius USA, Lexington, MA), had double-pool Kt/V Ն1.4, were on a thrice-weekly HD program, and had signs of deranged nutrition status, as defined by levels of several serum proteins below National Kidney Foundation Kidney Disease Outcomes Quality Initiative (K/DOQI) Nutritional Guidelines recommended targets, including serum albumin Ͻ4 g/dl, serum prealbumin Ͻ30 mg/dl, cholesterol Ͻ150 mg/dl, and serum transferrin Ͻ150 mg/dl for 3 consecutive months

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Randomized double-blind trial of oral essential amino acids for dialysis-associated hypoalbuminemia

Abstract: Oral EAAs induce a significant improvement in the serum albumin concentration in hemodialysis but not peritoneal dialysis subjects. Further study of their long-term effects on morbidity and mortality is warranted.

Cited by 118 publications

References 38 publications

Comparison of Intraperitoneal Amino Acid and Oral Amino Acid Supplements in Peritoneal Dialysis Patients

Comparison of Intraperitoneal Amino Acid and Oral Amino Acid Supplements in Peritoneal Dialysis Patients

Nutritional status among peritoneal dialysis patients after oral supplement with ONCE dialyze formula

Intradialytic Oral Nutrition Improves Protein Homeostasis in Chronic Hemodialysis Patients with Deranged Nutritional Status

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