News: Protein supplement tied to improvements for patients on dialysis, study finds

Intradialytic oral protein supplementation was found to be linked to improvements in several nutritional markers and real-world outcomes for patients on hemodialysis, according to a quality improvement study published by the National Kidney Foundation.

The study followed 24 hemodialysis patients who had serum albumin levels below 4.0 g/dL for at least three months. Participants were given a 1-oz. liquid protein supplement containing 15g of protein at the end of each session for 12 months.

After 12 months, patients who received a liquid protein supplement at the end of each dialysis session had significant improvements in real-world outcomes. The frequency of hospitalizations dropped from 4.02 to 2.60 times per month, and the average duration of hospital stays decreased from 5.71 to four days per month, reported Firouzeh Jazayeri, MSPH, RD, of UF Health in Gainesville, Florida.

Patients also demonstrated improved hemodialysis adequacy, with Kt/V rising from 1.56 to 1.69. This indicates how effectively dialysis removes uremic toxins and the rise suggestions improved treatment efficiency. The normalized protein catabolic rate (nPCR)—a measure of protein breakdown in the body—increased. There was also significant positive correlation between nPCR and Kt/V (r=0.63, P=0.02), suggesting that higher protein intake is associated with better solute clearance and treatment efficiency.

"This initiative demonstrates that nutrition and dialysis adequacy are not separate targets, but closely interconnected," Jazayeri noted. "Our findings suggest that intradialytic protein supplementation can improve nutritional status without compromising dialysis adequacy, and may even support better clearance outcomes."

Through the intervention, patients experienced significant improvements in serum albumin, with the largest gains occurring in the first six months. Albumin is the most abundant protein in the body and serves as a primary marker of protein energy wasting, Jazayeri explained. Low albumin is one of the strongest predictors of poor dialysis outcomes. Jazayeri also explained that when protein energy wasting is present, it can negatively affect a patient's tolerance to treatment.

"As we all know, protein energy wasting is common and frequently under-recognized in this population," she said. It "starts at the very early stage of the renal failure and continues to progress as the kidney function declines. Protein energy wasting contributes to muscle loss, fatigue, reduced functional status, and poor recovery from illness."

Editor’s note: To read the full study, click here. To read additional coverage from MedPage Today, click here.