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Impact of Modified Dietary Education Combined with High Energy/Protein Meals during Hemodialysis Treatment on Protein and Phosphorus Intake and Nutritional Status in Hypoalbuminemic Hemodialysis Patients
Author(s) -
Dizon Francis,
Wang Long,
Parsons Tara,
Gray Virginia,
Reiboldt Wendy
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.1159.5
Subject(s) - medicine , calorie , hemodialysis , malnutrition , meal , hypoalbuminemia , dialysis , serum albumin , population , environmental health
Background Low serum albumin and a high dietary phosphorus to dietary protein ratio (PPR) have been tied to malnutrition among maintenance hemodialysis (MHD) patients. In turn, malnutrition is an alarming risk factor for increased mortality amongst this population. The administration of high protein/high calorie meals during dialysis in tandem with modified nutrition education may help alleviate hypoalbuminemia and an elevated PPR. Research on these strategies is limited. Methods An 8‐week randomized control trial of 110 MHD participants (18 to 85 years, mean age = 54±15 SD, 48 males, 62 females) with serum albumin <4.0 g/dL from DaVita Dialysis centers in the greater Los Angeles area was conducted. The intervention group (n=55) was provided with high protein/high calorie meals during MHD as well as outpatient nutrition education that focused on lowering dietary phosphorus intake, while the control group (n=55) received low protein/low calorie meals and minimal nutrition education. Dietary intake data were collected from a 3‐day food diary or 24‐hour recall and meal intake forms during MHD treatment. Independent samples t‐tests were used to examine pre‐ and post‐study changes in 1) dietary intake in MHD patients expressed by PPR and 2) serum albumin, with a significance level of p ≤ 0.05. Results No significant association was found between intervention (meal provision during MHD treatment and modified nutrition education) and serum albumin ( t = −0.21, p = 0.84). While not significant at p ≤ 0.05, there was a near significant difference in changes in PPR ( t = −1.71, p = 0.09) between the intervention and control groups. PPR was shown to decrease in the intervention group post‐study. Conclusion This study found a near significant association between meal provision during MHD treatment combined with modified nutrition education and changes in PPR post‐study, but not with serum albumin levels. These results indicate a need for further studies of meal provision during MHD treatment as well as longer‐term studies on modified nutrition education in an effort to establish dietary behavior change and decrease PPR. Support or Funding Information This study was supported by the Los Angeles Biomedical Research Institute, as part of the Fosrenol for Enhancing Dietary Protein Intake in Hypoalbuminemic Dialysis Patients Study