DIETARY INTERVENTION AND PROTEIN SUPPLEMENTATION IN CHRONIC KIDNEY DISEASE PATIENTS UNDERGOING HEMODIALYSIS
Objective: The present study was conducted with the aim to assess and analyze the nutritional status of patients (>30yrs) undergoing haemodialysis.
Method: 50 subjects were enrolled in the study (32 males and 18 females). Various biochemical parameters such as Sodium, Potassium, Creatinine,
Phosphorus, Albumin etc along with amount of calorie and protein intake were compared pre and post nutritional counseling and protein
supplementation for 30 days during ongoing haemodialysis.
Result: Short term implication showed a significant statistical difference in the biochemical parameters. Adequate dietary counseling along with oral
nutritional supplementation given during haemodialysis improved the nutritional status of malnourished Chronic Kidney Disease patient. About 81%
of the patients showed proficient response whereas the remaining 18% showed a moderate improvement in their nutritional status.
Conclusion: Patients undergoing haemodialysis commonly develop protein-energy malnutrition which is associated with poor survival. Special
nutritional care is required for the dialysis patient to improve the net protein anabolism.
Keywords: Hemodialysis, Protein, Chronic kidney disease, Nutritional status, Malnutrition.
1. Zeier M. Risk of mortality in patients with end-stage renal disease: The role of malnutrition and possible therapeutic implications. Horm Res 2002;58 Suppl 3:30-4.
2. Clapp W. Renal anatomy. Silvaâ€™s Diagnostic Renal Pathology. New York: Cambridge University Press; 2009.
3. National Kidney Foundation. Kidney disease outcomes quality initiative
Fig. 1: The increase in the calorie intake and comparison to the ideal requirement
Fig. 2: The increase in the protein intake and comparison to the ideal requirement
Table 2: Depicting the macronutrient requirements for the HD patients
Macronutrients and fiber
1.2 g/kg/day (at least 50% of high biological value)
25-30% of total energy intake
50-55% of total energy intake (especially complex carbohydrates)
DPI: Dietary protein intake, DEI: Daily energy intake, HD: Hemodialysis
Table 3: Depicting the micronutrient requirement by the HD patients
Minerals and water (range of intake)
Usually 750-1500 ml/day
Table 4: Depicting the changes in the anthropometric and biochemical parameters of the subjects
Body weight (kg)
Serum albumin (g/L)
BMI: Body mass index
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clinical practice guidelines for nutrition in chronic renal failure. Am J Kidney Dis 2000;35:17-55.
4. Walter F, Boron C. Medical Physiology: A Cellular and Molecular Approach. Philadelphia: Elsevier, Saunders ISBN; 2004. p. 1-328-43.
5. Hakim RM, Levin N. Malnutrition in hemodialysis patients. Am J Kidney Dis 1993;21:125-37.
6. Owen WF. Nutritional status and survival in end-stage renal disease patients. Miner Electrolyte Metab 1998;24(1):72-81.
7. Blagg C. Importance of nutrition in dialysis patients. Am J Kidney Dis 1991;17:458-62.
8. Cano N. Malnutrition and chronic renal failure. Ann Med Interne 2000;151(7):563-74.
9. Acchiardo SR, Moore LW, Latour PA. Malnutrition as the main factor in morbidity and mortality of hemodialysis patients. Kidney Int Suppl 1983;16:S199-203.
10. LavÄ±lle M, Fouque D. Nutritional aspects in hemodialysis. Kidney Int 2000;58:133-9.
11. Kopple JD. Therapeutic approaches to malnutrition in chronic dialysis patients: the different modalities of nutritional support. Am J Kidney Dis 1999;33(1):180-5.
12. Veeneman JM, Kingma HA, Boer TS, Stellaard F, De Jong PE, Reijngoud DJ, et al. Protein intake during hemodialysis maintains a positive whole body protein balance in chronic hemodialysis patients. Am J Physiol Endocrinol Metab 2003;284(5):E954-65.
13. Mahan K, Escott-Stump S, Raymond J. Krauseâ€™s Food and the Nutrition Care Process. 13th ed. St. Louis, MO: Elsevier; 2012.
14. Stark S, Snetselaar L, Hall B, Stone RA, Kim S, Piraino B, et al. Nutritional intake in adult hemodialysis patients. J Clin Nutr 2011;26:45-56.
15. Sen D, Prakash J. Nutrition in dialysis patients. J Assoc Physicians India 2000;48:724-30.
16. Sharma RK, Sahu KM. Nutrition in dialysis patients. J Indian Med Assoc 2001;99:206-8.
17. Sobh MA, Sheashaa H, Tantawy AE, Ghoneim MA. Study of effect of optimization of dialysis and protein intake on neuromuscular function in patients under maintenance hemodialysis treatment. Am J Nephrol 1998;18(5):399-403.
18. Fouque D, Guebre-Egziabher F, Laville M. Advances in anabolic interventions for malnourished dialysis patients. J Ren Nutr 2003;13(2):161-5.
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