Protein–energy wasting occurs frequently during maintenance dialysis. Known aetiologies include a loss of nutrients during the haemodialysis procedure and anorexia. Providing energy and protein during dialysis improves metabolism; however, the benefits of long-term support are debated. Weiner and colleagues report convincing data with an intradialytic oral nutritional intervention using protein supplements.
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References
Fouque, D. et al. A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease. Kidney Int. 73, 391–398 (2008).
Kalantar-Zadeh, K. et al. Diets and enteral supplements for improving outcomes in chronic kidney disease. Nat. Rev. Nephrol. 7, 369–384 (2011).
Weiner, D. E. et al. Oral intradialytic nutritional supplement use and mortality in hemodialysis patients. Am. J. Kidney Dis. http://dx.doi.org/10.1053/j.ajkd.2013.08.007.
Kobayashi, H. et al. Reduced amino acid availability inhibits muscle protein synthesis and decreases activity of initiation factor eIF2B. Am. J. Physiol. Endocrinol. Metab. 284, E488–E498 (2003).
Veeneman, J. M. et al. Protein intake during hemodialysis maintains a positive whole body protein balance in chronic hemodialysis patients. Am. J. Physiol. Endocrinol. Metab. 284, E954–E965 (2003).
Cano, N. J. et al. Intradialytic parenteral nutrition does not improve survival in malnourished hemodialysis patients: a 2-year multicenter, prospective, randomized study. J. Am. Soc. Nephrol. 18, 2583–2591 (2007).
Fouque, D. et al. Use of a renal-specific oral supplement by haemodialysis patients with low protein intake does not increase the need for phosphate binders and may prevent a decline in nutritional status and quality of life. Nephrol. Dial. Transplant. 23, 2902–2910 (2008).
Lacson, E. Jr, Wang, W., Zebrowski, B., Wingard, R. & Hakim, R. M. Outcomes associated with intradialytic oral nutritional supplements in patients undergoing maintenance hemodialysis: a quality improvement report. Am. J. Kidney Dis. 60, 591–600 (2012).
Fouque, D., Pelletier, S., Mafra, D. & Chauveau, P. Nutrition and chronic kidney disease. Kidney Int. 80, 348–357 (2011).
Pison, C. M. et al. Multimodal nutritional rehabilitation improves clinical outcomes of malnourished patients with chronic respiratory failure: a randomised controlled trial. Thorax 66, 953–960 (2011).
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D. Fouque has received consultancy and honoraria for speaking from Abbott, Danone and Fresenius Kabi. L. Koppe declares no competing interests.
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Koppe, L., Fouque, D. Intradialytic oral nutrition—the ultimate conviction. Nat Rev Nephrol 10, 11–12 (2014). https://doi.org/10.1038/nrneph.2013.253
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DOI: https://doi.org/10.1038/nrneph.2013.253
