Objectives: To investigate the improvement of protein-energy wasting (PEW) in hemodialysis patients after supplementation with Lexineng nutritional supplements. Methods: A total of 90 patients who had been on maintenance haemodialysis for more than 3 months and met the diagnosis of PEW in the hemodialysis units of 6 hospitals in Jiangxi Province were collected and randomly divided into a control group and a test group of 45 patients each. After the patients were given dietary instructions, the corresponding number of calories in the test group was replaced by one can of Lexineng supplement daily for 3 months. Changes in body mass index, laboratory parameters such as haemoglobin and albumin and assessment of safety effects were observed in both groups before and after 3 months of treatment with Lexineng supplementation.Results:A total of 90 patients were included in the study and 84 patients (41 in the control group and 43 in the trial group) eventually completed the trial as required, of whom 47 (55.95%) were male and the mean age was (61.6±11.39) years. The mean mineral intake levels were similar and the differences in the indicators between the two groups were not significant (p>0.05). After 3 months of the trial, the results showed that the changes in body measurements such as weight (Wt) and BMI in the control group were not significant compared to those before the trial (p>0.05), while the Wt、BMI increased significantly and the subjective global assessment (SGA) decreased significantly in the trial group (p<0.05). Serum albumin (Alb) and haemoglobin increased in both groups compared to the pre-test, with Alb and haemoglobin increasing more significantly in the test group (p<0.001), and albumin and haemoglobin were significantly higher compared to the control group (p<0.05); Leukodystrophy was also significant in reducing serum creatinine levels and increasing serum calcium concentrations (p<0.05), and was able to reduce blood glucose levels without increasing the fat burden.Conclusion: Sustained supplementation with Lexineng on maintenance hemodialysis is effective in improving PEW symptoms and other complications in haemodialysis patients in many ways.
WANG Yu
,
ZHAO Qing
,
CHEN Qin-Kai
. Clinical study on the improvement of protein depletion in hemodialysis patients by the intervention of oral nutritional supplement [J]. Chinese Journal of Blood Purification, 2023
, 22(1)
: 11
-16
.
DOI: 10.3969/j.issn.1671-4091.2023.01.003
1.Fouque D, Kalantar-Zadeh K, Kopple J, et al. A proposed Nomenclature and diagnostic criteia for protein- energy wasting in acute and chronic disease[J]. Kidney Int. 2008.73(4):391-398.
2.ISRNM. Eating During Hemodialysis Treatment: A Consensus Statement From the International Society of Renal Nutrition and Metabolism[J]. J Ren Nutr. 2018 Jan;28(1):4-12.
3.Mazairac AH, de Wit GA, Grooteman MP, et al. A composite score of protein-energy nutritional statuspredicts mortality in haemodialysis patients no better than its individual components[J]. Nephrol Dial Transplant 2011;26:1962-7.
4.Luxia Zhang, Fang Wang, Li Wang。et al. Prevalence of chronic kidney disease in China: a cross-sectional survey[J].Lancet 2012; 379: 815-822.
5.程立新.中国血液净化[J]. 2004，3（8）：450-452
6.T. Alp Ikizler, Noel J. Cano, Harold Franch, et,al. Prevention and treatment of protein energy wasting in chronic kidney disease patients: a consensus statement by the International Society of Renal Nutrition and Metabolism[J]. Kidney International (2013) 84, 1096–1107
7.李杰，文青松，吴春林等. 维持性血液透析病人的营养评价及营养支持治疗[J]. 右江医学，2012，40（1）：8-10
8. Cuppari L, Avesani CM. Energy requirements in patients with chronic kidney disease[J]. J Ren Nutr. 2004;14:121-126.
9. Brandon M. Kistler, PhD, RD, Debbie Benne. et al. Eating During Hemodialysis Treatment:A consensus Statement From the International Society of Renal Nutrition and Metabolism[J]. Journal of Renal Nutrition, Vol 28, No 1 (January), 2018: pp 4-12
10.杨月欣等，《中国食品成分表：标准版（第六版）》[M]. 北京大学医学出版社，2018,07.
11.Cosola C, Rocchetti MT, Cupisti A, Gesualdo L. Microbiota metabolites: pivotal players of cardiovascular damage in chronic kidney disease. Pharmacol Res. 2018;130:132-142.
12.施咏梅，曹伟新．维持性透析患者的营养干预[J]．中国临床营养杂志，2007,15(1):
46
13.Eduardo A. Oliveira, Ronghao Zheng, Caitlin E. Carter, et,al. Cachexia/Protein energy wasting syndrome in CKD: Causation and treatment[J]. Seminars in Dialysis. 2019;32:493–499.
14.Alice Sabatinoc, Giovanni Piotti, Carmela Cosola, et,al. Dietary protein and nutritional supplements in conventional Hemodialysis[J]. Seminars in Dialysis. 2018;31:583–591.
15.Arisa Inoue, Eiji Ishikawa , Yumiko Shirai, et,al. Effects of Protein-Energy Wasting (PEW) and hyperphosphatemia on the prognosis in Japanese maintenance hemodialysis patients: A five year follow-up observational study[J]. Clinical Nutrition ESPEN 36 (2020) :134-138
16.Ikizler TA. Using and interpreting serum albumin and prealbumin as nutritional markers in patients on chronic dialysis[J]. Sem Dial. 2014;27:590-592.
17.Ikizler TA, Cano NJ, Franch H, Fouque D, Himmelfarb J, Kalantar-Zadeh K, et al.Prevention and treatment of protein energy wasting in chronic kidney diseasepatients: a consensus statement by the International Society of Renal Nutritionand Metabolism. Kidney Int. 2013;84:1096-107.
