Safety and tolerance of medical nutritional products as sole sources of nutrition in people on hemodialysis

Cockram, David B.; Hensley, Mary Kay; Rodríguez, M P Amador; Agarwal, Garima; Wennberg, Ann K.; Ruey, Peter; Ashbach, David; Hebert, Lee A.; Kunau, R. T.

doi:10.1016/s1051-2276(98)90034-6

Cited by 57 publications

(60 citation statements)

References 14 publications

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“…[8] Cockram et al . [9] studied the effects of medical nutritional products in hemodialysis patients and found good tolerability but in short-term study of 10 days. Phillips[10] studied with oral essential amino acid supplements in only 16 patients.…”

Section: Discussionmentioning

confidence: 99%

Are oral protein supplements helpful in the management of malnutrition in dialysis patients?

Jeloka¹,

Dharmatti²,

Jamdade³

2013

Indian J Nephrol

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A randomized study was planned to compare the effects of whey and egg albumin protein supplements in dialysis patients. Fifty adult patients were randomized to receive either whey protein or egg albumin as per their deficit calculated from K/DOQI recommendations. Actual intake was calculated from three-day dietary diary. Assessment of nutritional status was done by serum albumin and bioelectric impedance analysis (BIA). Repeat evaluation was done after 6 months. The mean initial intake of protein in whey and egg albumin group was 0.74 ± 0.3 vs. 0.69 ± 0.2 g/kg/day, (P = 0.5) and calorie intake was 20 ± 5.6 vs. 20.5 ± 5.1 kcal/kg/day, (P = 0.8), respectively. Out of 50 patients, two died within 2 months and were excluded from the study and 14 (28%) dropped out within one month because of side effects. The most common side effect in drop-outs was nausea and vomiting (43%). Out of remaining 34 patients who completed the study, 80% could not consume >50% of the recommended supplement because of side effects. The protein and calorie intake remained similar at baseline and 6 months in both the groups. The main side effects in whey group were bloating and nausea with vomiting, and in egg protein group were nausea with vomiting, bloating and anorexia. Oral protein supplements were not tolerated in dialysis patients and side effects resulted in high degree of non-compliance.

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Section: Discussionmentioning

confidence: 99%

Are oral protein supplements helpful in the management of malnutrition in dialysis patients?

Jeloka¹,

Dharmatti²,

Jamdade³

2013

Indian J Nephrol

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“…Kopple showed the lack of randomized studies observing the effects of nutritional supplements in HD patients . Cockram et al . studied the effects of medical nutritional products in HD patients in a short period of 10 days.…”

Section: Discussionmentioning

confidence: 99%

“…MIS scoring includes 10 parameters, with 4 grades according to their severity, as shown in Table . According to the MIS, patients were classified into normal (score <5), mild‐moderate, and severe malnutrition (>10).…”

Section: Methodsmentioning

confidence: 99%

Effect of high‐protein supplemental therapy on subjective global assessment of CKD‐5D patients

Yuvaraj

Vijayan

Alex

et al. 2015

Hemodialysis International

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Adequate nutrition in patients on hemodialysis is an important step for improving the quality of life. This prospective study was undertaken to monitor the nutritional status of patients who were given high-protein supplements on malnutrition inflammation score (MIS) and to correlate with biochemical parameters in maintenance hemodialysis (MHD) patients. This prospective study was conducted on 55 chronic kidney disease patients on MHD (37 women, 18 men), aged between 21 and 67 years. Of the 55 patients, 26 patients received high-protein commercial nutritional supplements, whereas 29 patients received high-protein kitchen feeding. Every patient had their MIS, 24-hour dietary recall, hand grip, mid arm circumference, triceps skin-fold thickness at 0, 3, and 6 months. Each of the above parameters was compared between the high-protein commercial nutritional supplement cohort and high-protein kitchen feeding cohort, and the data were analyzed. Of the 55 patients, 82.61% of patients on high-protein kitchen feeding group and 66.67% in high-protein commercial nutritional supplement group were nonvegetarian (P = 0.021). According to the MIS, improvement was observed in malnutrition status from 3- to 6-month period in 38.1% of patients in high-protein commercial supplement group, whereas only in 8.7% in high-protein kitchen feeding group (P = 0.04). Assessment showed improvement in malnutrition status with high-protein commercial nutritional supplement, which was marked in patients with age group >65 years (P = 0.03) and in those in whom serum albumin is <35 g/L (P = 0.02). Both high-protein kitchen feeding and high-protein commercial nutritional supplement cohorts were observed to have improvement in overall nutritional status. Older patients >65 years with lower serum albumin levels (<3.5 g/dL) were observed to have significant improvement in nutritional status with high-protein commercial nutritional supplements.

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“…Campbell et al (1997) demonstrated that consumption of an FOS containing formula did not increase stool concentration of bi®dobacteria compared with a low-residue formula. The addition of a prebiotic to enteral formulae was shown to have no effect on stool frequency and consistency in patients consuming enteral formula orally (Cockram et al, 1998) or patients receiving ETF (Sobotka et al, 1997). The addition of a prebiotic to enteral formulae was shown to have no effect on stool frequency and consistency in patients consuming enteral formula orally (Cockram et al, 1998) or patients receiving ETF (Sobotka et al, 1997).…”

Section: Enteral Tube Feeding and Diarrhoea 427mentioning

confidence: 97%

The role of probiotics and prebiotics in the management of diarrhoea associated with enteral tube feeding

Whelan

Gibson

Judd

et al. 2001

J Human Nutrition Diet

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Safety and tolerance of medical nutritional products as sole sources of nutrition in people on hemodialysis

Cited by 57 publications

References 14 publications

Are oral protein supplements helpful in the management of malnutrition in dialysis patients?

Are oral protein supplements helpful in the management of malnutrition in dialysis patients?

Effect of high‐protein supplemental therapy on subjective global assessment of CKD‐5D patients

The role of probiotics and prebiotics in the management of diarrhoea associated with enteral tube feeding

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