The effects of resistance exercise and oral nutritional supplementation during hemodialysis on indicators of nutritional status and quality of life

Martín-Alemañy, Geovana; Valdez-Ortiz, Rafael; Olvera-Soto, Guadalupe; Gómez-Guerrero, Irma; Aguire-Esquivel, Guillermo; Cantú-Quintanilla, Guillermo; López-Alvarenga, Juan Carlos; Miranda-Alatriste, Paola; Espinosa-Cuevas, Ángeles

doi:10.1093/ndt/gfw297

Cited by 71 publications

(85 citation statements)

References 48 publications

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“…In a retrospective evaluation of ONS in HD patients, authors observed a reduction in days of HD treatment missed and mortality risk, despite a lack of significant improvement in serum albumin [47]. Nutrition intake and anthropometric measures improved, and PEW was reduced in a randomized clinical trial of ONS in HD patients [48]. Increasing ONS use in HD patients with malnutrition risk should be further investigated to establish their inclusion as part of evidence-based patient care, as has been proposed by the ISRNM [49].…”

Section: Discussionmentioning

confidence: 99%

Malnutrition Risk in Hemodialysis Patients in Israel: Results of the Status of Nutrition In Hemodialysis Patients Survey Study

Boaz

Azoulay

Schwartz

et al. 2019

Nephron

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Background: Malnutrition is a frequently observed disorder in patients with chronic kidney disease (CKD) receiving hemodialysis (HD). While variously defined, malnutrition is a frequently observed condition among patients on HD. Prevalence estimates of malnutrition among Israeli HD patients have not been reported. Objectives: To survey nutrition intake in Israeli HD patients; estimate malnutrition risk prevalence; identify risk factors, and characterize malnutrition risk in HD patients. Methods: A representative sample of 378 Israeli HD patients treated in hospital HD centers throughout the country were surveyed. Using the 24-h recall method, dietary intake was estimated and the chronologically corresponding biochemistry, anthropometric, and hemodynamic measures were recorded. Four categories of malnutrition risk were defined: “minimal”: body mass index (BMI) > 23 kg/m² and serum albumin > 3.8 g/dL; “mild”: BMI < 23 kg/m² and albumin > 3.8 g/dL; “moderate”: BMI > 23 kg/m² and albumin < 3.8 g/dL; “severe”: BMI < 23 k/m² and serum albumin < 3.8 g/dL. Results: Elevated malnutrition risk was identified in 175 (46.3%) study participants, who were more likely to require feeding assistance, have major comorbidities, reduced hemoglobin, and elevated C-reactive protein. Oral nutrition supplementation was prescribed to only 14.3% of patients with elevated malnutrition risk. Intradialytic parenteral nutrition was recorded for 6 patients, all of whom had moderate or severe malnutrition risk. Less than one-third of patients met the guidelines for dietary intake of energy or protein, and this did not differ across malnutrition risk groups. Discussion: Elevated malnutrition risk is a frequent finding in HD patients treated in hospital settings in Israel. Dietary intake does not meet guidelines but does not differ across malnutrition risk categories. Nutrition supplements are underused in HD patients with high malnutrition risk. There is a need to expand the survey to community HD centers.

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Section: Discussionmentioning

confidence: 99%

Malnutrition Risk in Hemodialysis Patients in Israel: Results of the Status of Nutrition In Hemodialysis Patients Survey Study

Boaz

Azoulay

Schwartz

et al. 2019

Nephron

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“…Regarding the type of ION used, it should be noted that studies evaluating the use of both food and oral supplements have not shown one to be better than the other. Nutritional markers other than albumin and nitrogen balance have not been studied, including hand grip strength or physical functionality 31 or bioelectrical impedance. The present study found that HCP mostly perceives ION as a good opportunity to improve the QoL of HD patients, so it is important to evaluate this outcome.…”

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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“…Skeletal muscle mass increased through enteral nutrition therapy based on the results of an RCT comparing the effects of enteral nutritional supplementation only against leg muscle strength training plus enteral nutrition therapy in dialysis patients. No additional increases in skeletal muscle mass were determined to have resulted from the addition of leg strength training . Although most studies in this area have been small‐scale, exercise + nutritional supplementation could possibly help prevent sarcopenia in patients with CKD.…”

Section: Cq3: Can Interventions For Non‐communicable Diseases Preventmentioning

confidence: 99%

Chapter 3 Prevention of sarcopenia

Kuzuya

Sugimoto

Suzuki

et al. 2018

Geriatrics Gerontology Int

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The effects of resistance exercise and oral nutritional supplementation during hemodialysis on indicators of nutritional status and quality of life

Abstract: Oral nutritional supplementation during HD improves NS. The addition of RE during HD does not seem to augment the acute anabolic effects of intradialytic ONS on NS.

Cited by 71 publications

References 48 publications

Malnutrition Risk in Hemodialysis Patients in Israel: Results of the Status of Nutrition In Hemodialysis Patients Survey Study

Malnutrition Risk in Hemodialysis Patients in Israel: Results of the Status of Nutrition In Hemodialysis Patients Survey Study

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

Chapter 3 Prevention of sarcopenia

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