Amino acid profile after oral nutritional supplementation in hemodialysis patients with protein-energy wasting.

OBJECTIVES: Protein-energy wasting (PEW) is highly prevalent in patients on hemodialysis (HD). Oral nutritional supplementation (ONS) is recommended for malnourished patients on HD. The aim of this study was to evaluate ONS on plasma amino acid in HD patients with PEW.

METHODS: Thirty-two HD patients with a mean age 59.1 ± 9.5 y with PEW were enrolled into the study. Patients were prescribed ONS (125 mL twice a day for 3 mo) together with dietary advice. The nutritional status was evaluated by means of body mass index, Subjective Global Assessment, and serum albumin and prealbumin levels. The percentages of body fat and lean body mass were measured by means of the near-infrared method. The lean body mass-to-body weight ratios were calculated. Tumor necrosis factor, interleukin-6 and high-sensitivity C-reactive protein, were measured by the enzyme-linked immunosorbent assay method. Serum concentrations of amino acids were measured by the high-performance liquid chromatography method.

RESULTS: After 3 mo of ONS, a significant increase of both serum prealbumin and albumin was observed. The concentration of most of the amino acids increased independently on inflammation.

CONCLUSIONS: Dietary advice, combined with ONS, is effective in HD patients with PEW. Both dietary advice and ONS are needed to be sure that patients consume an adequate daily amount of calories and protein.