Your Health

Dialysis Removes Some Protein 

When dialysis filters out wastes from your blood, it also removes protein. If you don’t eat enough to make up for what’s lost, your body will start to use the protein from your muscles to get the energy it needs. This can cause:

Fatigue

Higher risk of infections

Weight loss

Dialysis Patients’ Need for Protein

Protein-energy malnutrition (PEM) is an all-too-common problem in dialysis centers, affecting an estimated 23% to 73% of patients receiving maintenance hemodialysis. 

The causes of PEM are many, and may include poor diet due to loss of appetite, protein catabolism caused by dialysis, chronic inflammation, and more.

Whatever the cause(s), patients with PEM are in danger. In adults, PEM is a powerful predictor of morbidity and mortality. In children, PEM is associated with growth retardation.

According to Dialysis Outcomes and Practice Patterns Study (DOPPS), the risk of mortality increases as serum albumin levels decrease. In fact, the mortality risk is more than twice as high for patients with serum albumin levels <3.3 g/dL when compared with patients who meet the 4.0 g/dL nutritional guideline. Similarly, DOPPS data show that low levels of serum creatinine (<10 mg/dL) were also associated with an increased mortality risk. 

KDOQI has proved to be difficult in practice to increase Serum Albumin with daily diets and Data collected by the Centers for Medicare and Medicaid Services (CMS) ESRD Clinical Performance Measures Project reveal that most dialysis patients are currently not meeting the guidelines for serum albumin.

Nutritional supplements is an effective means of helping needy dialysis patients improve serum albumin levels.

Supplement Improves Serum Albumin

Program Description

A 3-month supply of nutritional supplements( gms of powdered protein per day) was delivered directly to the clinic of each patient who qualified for the supplement program. 

To qualify, patients needed to meet the following criteria:

No Medicaid coverage (and meet other financial criteria)

Serum albumin <3.5 mg/dL for at least 2 of the last 3 months

-and/or-

Significant weight loss (>5% in 1 month or >10% in 6 months)

Total Patients – 130 ( Male 65 and Female 65)

Average Age - 62.3 years. T

99 hemodialysis patients and 31 peritoneal dialysis patients.

Positive Results

Data collected after 3 months of supplement use showed a statistically significant increase in serum albumin levels, from an average of 2.9 ± .4 mg/dl to 3.45 ± .4 mg/dL. Higher serum albumin levels continued throughout the 3-month supplementation period—and persisted for 3 more months after the supplementation was completed (average of 3.49 ± .4 mg/dL).

Patients with albumin levels less than 3.0 mg/dL received the most benefit from the nutritional supplements, with albumin levels improving more than 0.5 mg/dL on average (from 2.67 mg/dL to 3.3 mg/dL. P value <0.0005).

Reference

1.      Poole R, Hamad A, Thomas L, Strawhorn P. Impact of nutritional supplements on albumin levels of dialysis patients: nutrition supplement grant program NKF of South Carolina. Ren Nutr Forum 4:1-9, 2006.

 

 

 

 

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UNECE U-LP 200® is nutrition specifically designed to help meet the nutritional needs of Stage 1 to Stage 4 pre dialysis patient. More

 

Your Health

When dialysis filters out wastes from your blood, it also removes protein. If you don’t eat enough to make up for what’s lost, your body will start to use the protein from your muscles to ... More

 

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