Dietary management of haemodialysis patients with chronic kidney disease and malnourishment

Background and Objectives: Dietary supplementation for haemodialyzed (HD) patients with chronic kidney disease (CKD) and its benefits for the anthropometric profiles remain contentious. This study analysed changes inthe albumin levels and anthropometric profiles of HD patients within 3 months of nutritional therapy. Methodsand Study Design: Sixty-three malnourished HD patients (Subjective Global Assessment nutrition status B or C)were enrolled. Twenty patients received counselling, 17 patients received oral therapy, 26 patients received intradialyticparenteral nutrition (IDPN), and were evaluated at month 0, month 1, and month 3. Five patients withdrewbefore completing the trial. The patients’ albumin levels and anthropometric profiles (biceps and tricepsskinfold thickness, upper arm circumference, body weight, and body mass index) were analysed before and aftertreatment. We performed multivariate analysis to determine the effect of each treatment on serum albumin andanthropometric profiles. Results: At months 1 and 3, nutritional therapy was associated with different mean serumalbumin level among three nutritional intervention groups (p<0.05). Significant increases in serum albumin,upper arm circumference, and triceps and biceps skinfold thickness were identified in the counselling and IDPNgroups. Multivariate linear regression revealed significant differences between oral and nonoral groups in albuminand biceps and triceps skinfold thickness at months 1 and 3. These variables were affected by age and durationof haemodialysis (p<0.05).