Objective: We evaluated the impact of oral protein supplementation given during hemodialysis and peritoneal dialysis on nutritional status, number of hospitalizations, and length of stay.
Design: We used a randomized crossover design in which serum albumin, normalized protein catabolic rate (nPCR), total hospitalizations, and length of stay were compared in patients who received protein supplements with those who did not. The study was conducted for 1 year (November 2005 to October 2006).
Setting: This study was conducted at an outpatient dialysis facility.
Subjects: Forty-nine patients were treated with hemodialysis or peritoneal dialysis for at least 3 months.
Results: The nPCR significantly increased by month 4 of treatment from a baseline of 1.05 to 1.16 (P = .007). The control group had a significant decline in nPCR during the first 6 months, from 1.11 to 0.98 (P = .038). Improvement was evident in albumin by month 3, from 3.49 to 3.52 (P = .035), but this was not sustained. In the second 6 months, the control group had a significant drop, from 3.35 to 3.19 (P = .014), and the difference between the protein-supplementation and control groups was significant during the second 6 months (P = .037). The nPCR also dropped significantly (P = .024) for the control group in the second 6 months. When protein supplementation ended, weight dropped significantly for those with a body mass index of <20. Trends toward a reduction in hospitalization admissions and hospital days were seen in both crossover treatment groups.
Conclusions: In-center supplementation of protein generally improves serum markers of nutrition overall, and when it is discontinued, these markers decline. Larger studies are needed to confirm the trends that we observed regarding nutritional markers and reductions in hospitalizations and hospitalization days.