EFFECT OF RENAL SPECIFIC ORAL NUTRITION (ONCE RENAL) ON DIETARY INTAKE AND SERUM ELECTROLYTES IN CHRONIC KIDNEY DISEASE STAGE IV
DOI:
https://doi.org/10.55374/jseamed.v4i1.56Keywords:
Nutritional status, Serum electrolytes, Chronic kidney disease, Low protein diet supplement, Renal specific oral nutritionAbstract
Background and Objectives: Low nutritional intake is common in advanced chronic kidney disease (CKD) and poses a direct risk for malnutrition. Our study evaluated the effects of a renal specific oral nutrition (ONCE Renal) supplement concerning nutritional status, minerals and electrolytes among patients with stage IV CKD.
Methods and Study Design: A total of 32 CKD patients with an estimated glomerular filtration rate 16-29 mL/min/1.73 m2, well nourished subjects and anticipated good compliance with the diet received the ONCE Renal diet instead of 1 meal daily for 30 days. Dietary protein and energy intake, body compositions, and serum concentrations of urea, creatinine, calcium, magnesium, phosphate and albumin were assessed at baseline, and at 30 days. A dietary intake by three-day food record were also evaluated by a registered dietitian.
Results: At the end of 30 days, significant improvements in energy, fat, fiber and magnesium intake by dietary interview were noted. In addition, the patients also increased body weight and body mass index after supplement. No significant changes in renal function, serum electrolytes, calcium, phosphorus, magnesium concentration and other nutritional markers including serum albumin, body compositions and protein equivalence of total nitrogen appearance were observedduring study. The compliance with the ONCE Renal diet was good among enrolled patients and no adverse reactions were found.
Conclusions: Renal specific oral diet supplement can improve energy intake, body weight and maintain serum electrolytes concentrations among patients with stage IV CKD.
Metrics
References
Kovesdy CP, George SM, Anderson JE, Kalantar-Zadeh K. Outcome predictability of biomarkers of protein-energy wasting and inflammation in moderate and advanced chronic kidney disease. Am J Clin Nutr 2009; 90: 407-14. DOI: https://doi.org/10.3945/ajcn.2008.27390
Kovesdy CP, Anderson JE, Kalantar-Zadeh K. Paradoxical association between body mass index and mortality in men with CKD not yet on dialysis. Am J Kidney Dis 2007; 49: 581-91. DOI: https://doi.org/10.1053/j.ajkd.2007.02.277
Kalantar-Zadeh K, Ikizler TA, Block G, Avram MM, Kopple JD. Malnutrition-inflammation complex syndrome in dialysis patients: causes and consequences. Am J Kidney Dis 2003; 42: 864-81. DOI: https://doi.org/10.1016/j.ajkd.2003.07.016
Ballmer PE, McNurlan MA, Hulter HN, Anderson SE, Garlick PJ, Krapf R. Chronic metabolic acidosis decreases albumin synthesis and induces negative nitrogen balance in humans. J Clin Invest 1995; 95: 39-45. DOI: https://doi.org/10.1172/JCI117668
Avesani CM, Cuppari L, Silva AC, Sigulem DM, Cendoroglo M, Sesso R, et al. Resting energy expenditure in pre-dialysis diabetic patients. Nephrol Dial Transplant 2001; 16: 556-65. DOI: https://doi.org/10.1093/ndt/16.3.556
Cuppari L, de Carvalho AB, Avesani CM, Kamimura MA, Dos Santos Lobao RR, Draibe SA. Increased resting energy expenditure in hemodialysis patients with severe hyperparathyroidism. J Am Soc Nephrol 2004; 15: 2933-9. DOI: https://doi.org/10.1097/01.ASN.0000141961.49723.BC
Kovesdy CP, Kopple JD, Kalantar-Zadeh K. Management of protein-energy wasting in non-dialysis-dependent chronic kidney disease: reconciling low protein intake with nutritional therapy. Am J Clin Nutr 2013; 97: 1163-77. DOI: https://doi.org/10.3945/ajcn.112.036418
Kopple JD, Monteon FJ, Shaib JK. Effect of energy intake on nitrogen metabolism in nondialyzed patients with chronic renal failure. Kidney Int 1986; 29: 734-42. DOI: https://doi.org/10.1038/ki.1986.59
Dukkipati R, Kopple JD. Causes and prevention of protein-energy wasting in chronic kidney failure. Semin Nephrol 2009; 29: 39-49. DOI: https://doi.org/10.1016/j.semnephrol.2008.10.006
Supasyndh O, Satirapoj B, Seenamngoen S, Yongsiri S, Choovichian P, Vanichakarn S. Nutritional status of twice and thrice-weekly hemodialysis patients with weekly Kt/V > 3.6. J Med Assoc Thai 2009; 92: 624-31.
Cano N, Fiaccadori E, Tesinsky P, Toigo G, Druml W, Dgem, et al. ESPEN Guidelines on Enteral Nutrition: Adult renal failure. Clin Nutrition 2006; 25: 295-310. DOI: https://doi.org/10.1016/j.clnu.2006.01.023
Campbell KL, Ash S, Zabel R, McFarlane C, Juffs P, Bauer JD. Implementation of standardized nutrition guidelines by renal dietitians is associated with improved nutrition status. Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation. 2009; 19: 136-44. DOI: https://doi.org/10.1053/j.jrn.2008.11.002
Sharma M, Rao M, Jacob S, Jacob CK. A controlled trial of intermittent enteral nutrient supplementation in maintenance hemodialysis patients. J Ren Nutr 2002; 12: 229-37. DOI: https://doi.org/10.1053/jren.2002.35300
Kidney Disease Outcomes Quality I. K/ DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. American journal of kidney diseases : the official Journal of the National Kidney Foundation. 2004; 43(5 Suppl 1): S1-290. DOI: https://doi.org/10.1053/j.ajkd.2004.03.003
Cano NJ, Aparicio M, Brunori G, Carrero JJ, Cianciaruso B, Fiaccadori E, et al. ESPEN Guidelines on Parenteral Nutrition: adult renal failure. Clin Nutr 2009; 28: 401-14. DOI: https://doi.org/10.1016/j.clnu.2009.05.016
Chang JH, Kim DK, Park JT, Kang EW, Yoo TH, Kim BS, et al. Influence of ketoanalogs supplementation on the progression in chronic kidney disease patients who had training on low-protein diet. Nephrology. 2009; 14: 750-7. DOI: https://doi.org/10.1111/j.1440-1797.2009.01115.x
Teplan V, Schuck O, Knotek A, Hajny J, Horackova M, Skibova J, et al. Effects of low-protein diet supplemented with ketoacids and erythropoietin in chronic renal failure: a long-term metabolic study. Annals of transplantation : quarterly of the Polish Transplantation Society 2001; 6: 47-53.
Caglar K, Fedje L, Dimmitt R, Hakim RM, Shyr Y, Ikizler TA. Therapeutic effects of oral nutritional supplementation during hemodialysis. Kidney Int 2002; 62: 1054-9. DOI: https://doi.org/10.1046/j.1523-1755.2002.00530.x
Satirapoj B, Prapakorn J, Punpanich D, Pongsuparbchon C, Supasyndh O. The effect of ONCE Renal on minerals and electrolytes in predialysis patients with chronic kidney disease. Int J Nephrol Renovasc Dis 2016; 9: 81-6. DOI: https://doi.org/10.2147/IJNRD.S98179
Stratton RJ, Bircher G, Fouque D, Stenvinkel P, de Mutsert R, Engfer M, et al. Multinutrient oral supplements and tube feeding in maintenance dialysis: a systematic review and meta-analysis. Am J Kidney Dis 2005; 46: 387-405. DOI: https://doi.org/10.1053/j.ajkd.2005.04.036
de Waal D, Heaslip E, Callas P. Medical Nutrition Therapy for Chronic Kidney Disease Improves Biomarkers and Slows Time to Dialysis. J Ren Nutr 2016; 26: 1-9. DOI: https://doi.org/10.1053/j.jrn.2015.08.002
Moore H, Reams SM, Wiesen K, Nolph KD, Khanna R, Laothong C, et al. National Kidney Foundation Council on Renal Nutrition survey: past-present clinical practices and future strategic planning. J Ren Nutr 2003; 13: 233-40. DOI: https://doi.org/10.1016/S1051-2276(03)00075-X
Huang MC, Chen ME, Hung HC, Chen HC, Chang WT, Lee CH, et al. Inadequate energy and excess protein intakes may be associated with worsening renal function in chronic kidney disease. J Ren Nutr 2008; 18: 187-94. DOI: https://doi.org/10.1053/j.jrn.2007.08.003
Beto JA, Schury KA, Bansal VK. Strategies to promote adherence to nutritional advice in patients with chronic kidney disease: a narrative review and commentary. Int J Nephrol Renovasc Dis 2016; 9: 21-33. DOI: https://doi.org/10.2147/IJNRD.S76831
Aparicio M, Bellizzi V, Chauveau P, Cupisti A, Ecder T, Fouque D, et al. Do ketoanalogues still have a role in delaying dialysis initiation in CKD predialysis patients? Semin Dial 2013; 26: 714-9. DOI: https://doi.org/10.1111/sdi.12132
Garneata L, Stancu A, Dragomir D, Stefan G, Mircescu G. Ketoanalogue-Supplemented Vegetarian Very Low-Protein Diet and CKD Progression. J Am Soc Nephrol 2016; 27: 2164-76. DOI: https://doi.org/10.1681/ASN.2015040369
Institute of Nutrition, Mahidol University. Nutrients calculation software: INMUCALNutrients V.3.2 Database version NB.3, Thailand, 2018.r
Downloads
Published
How to Cite
Issue
Section
License
The Journal of Southeast Asian Medical Research will hold the copyright to all published articles. The publisher's production department handles copyright forms once a manuscript is accepted and scheduled for publication.
