Muscle Status to Oral Nutritional Supplementation in Hemodialysis Patients With Protein Energy Wasting

This study is a multi-centred randomized, open label-controlled trial where a total of 54 HD patients (29 intervention; 27 control) with PEW were recruited from government, private and non-governmental organization settings. Patients were randomized to either the intervention or control group. The intervention group received ONS (475 kcal and 21.7 g of protein), daily for 6 months. Both intervention and control group received standard nutritional counseling during the study period.

Patients who consented were subjected to a screening for identification of PEW and other eligibility criteria. Patients who fulfilled the inclusion criteria were randomized to either control or intervention group. During the 6 months of treatment period, patients in both control and intervention groups were assessed at baseline, 3rd months and 6th months for changes in muscle status using ultrasound imaging and bio-impedance spectroscopy method, malnutrition inflammation complex syndrome using Malnutrition-Inflammation Score, and other measures indicative of nutritional status including anthropometry, biochemistry, dietary intake and quality of life assessment. These parameters were compared at baseline and 6 months for within and between group differences using general linear model test.

Inclusion criteria

• HD patients receiving standard dialysis treatment (3 sessions per week, 4 hours per session) for >3 months
• Aged between 18 to 70 years old
• Diagnosed with PEW using the ISRNM criteria

Exclusion criteria

• History of poor adherence to HD treatment
• Prolonged hospitalization or surgery in the past 3 months prior to recruitment
• Diagnosed with inflammatory diseases or malignancy
• Vegetarian
• Regular intake of ONS