Long-term oral nutrition supplementation improves outcomes in malnourished patients with chronic kidney disease on hemodialysis

JPEN J Parenter Enteral Nutr. 2014 Nov;38(8):960-5. doi: 10.1177/0148607113517266. Epub 2014 Jan 16.


Background: There is no consensus on the type, time of initiation, or duration of use of enteral nutrition in patients with chronic kidney disease (CKD). This study aimed to compare the effects of a renal-specific oral nutrition supplement (RS-ONS) and a standard recommended nutrition regime on biochemical and nutrition markers in malnourished patients with CKD on hemodialysis.

Methods: Sixty-two malnourished patients with CKD, divided into experimental (RS-ONS; n = 32; mean [SD] age, 62.0 [11.3] years; 55.2% female) and control (CON; n = 30; mean [SD] age, 57.2 [12.3] years; 31% female) groups, were evaluated for anthropometric, biochemical, and inflammatory parameters.

Results: Mean (SD) serum albumin levels were significantly increased in the RS-ONS group from 3.5 (0.3) g/dL at baseline to 3.7 (0.2) g/dL at 6 months (P = .028). Significantly fewer patients had serum albumin levels of <3.5 g/dL after month 6. Dry weight of patients significantly increased in the RS-ONS but decreased in the CON groups (P < .001 for each). Percent change from baseline revealed negative results for bioelectrical impedance analysis (P < .001) in the CON group. Malnutrition inflammation score at 6 months (P = .006) and erythropoietin (EPO) dose requirements were higher in the CON group (P = .012).

Conclusions: Our findings indicate that consuming RS-ONS improves serum albumin and anthropometric measures, as well as reduces EPO dose, in patients with CKD.

Keywords: anthropometrics; chronic renal disease; dialysis; malnutrition; oral nutritional supplements.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Aged
  • Body Weight
  • Dietary Supplements*
  • Electric Impedance
  • Erythropoietin / administration & dosage
  • Female
  • Humans
  • Male
  • Malnutrition / blood
  • Malnutrition / diet therapy*
  • Malnutrition / etiology
  • Middle Aged
  • Nutritional Status*
  • Renal Dialysis / adverse effects*
  • Renal Insufficiency, Chronic / blood
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / therapy*
  • Serum Albumin / metabolism*


  • Serum Albumin
  • Erythropoietin