Are oral protein supplements helpful in the management of malnutrition in dialysis patients?
Are oral protein supplements helpful in the management of malnutrition in dialysis patients?
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DOI：
10.4103/0971-4065.107185
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发表时间：
2013-01-01
影响因子：
0.8
通讯作者：
Pandit, M
中科院分区：
文献类型：
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作者：
Jeloka, T K;Dharmatti, G;Pandit, M
计划进行一项随机研究，比较乳清和卵清蛋白蛋白补充剂对透析患者的影响。根据K/DOQI建议计算的缺陷，50名成人患者随机接受乳清蛋白或卵清蛋白。根据三天饮食日记计算实际摄入量。通过血清白蛋白和生物电阻抗分析（BIA）评估营养状况。6个月后进行重复评估。乳清和卵清蛋白组的平均初始蛋白质摄入量分别为0.74 ± 0.3和0.69 ± 0.2 g/kg/d（P = 0.5），热量摄入量分别为20 ± 5.6和20.5 ± 5.1 kcal/kg/d（P = 0.8）。在50名患者中，2名在2个月内死亡，被排除在研究之外，14名（28%）在一个月内因副作用而退出。脱落者中最常见的副作用是恶心和呕吐（43%）。在其余34名完成研究的患者中，80%的人由于副作用而无法摄入超过50%的推荐补充剂。两组的蛋白质和卡路里摄入量在基线和6个月时保持相似。乳清组主要不良反应为腹胀、恶心呕吐，鸡蛋蛋白组主要不良反应为恶心呕吐、腹胀、厌食。口服蛋白质补充剂在透析患者中不耐受，副作用导致高度不依从性。
A randomized study was planned to compare the effects of whey and egg albumin protein supplements in dialysis patients. Fifty adult patients were randomized to receive either whey protein or egg albumin as per their deficit calculated from K/DOQI recommendations. Actual intake was calculated from three-day dietary diary. Assessment of nutritional status was done by serum albumin and bioelectric impedance analysis (BIA). Repeat evaluation was done after 6 months. The mean initial intake of protein in whey and egg albumin group was 0.74 ± 0.3 vs. 0.69 ± 0.2 g/kg/day, (P = 0.5) and calorie intake was 20 ± 5.6 vs. 20.5 ± 5.1 kcal/kg/day, (P = 0.8), respectively. Out of 50 patients, two died within 2 months and were excluded from the study and 14 (28%) dropped out within one month because of side effects. The most common side effect in drop-outs was nausea and vomiting (43%). Out of remaining 34 patients who completed the study, 80% could not consume >50% of the recommended supplement because of side effects. The protein and calorie intake remained similar at baseline and 6 months in both the groups. The main side effects in whey group were bloating and nausea with vomiting, and in egg protein group were nausea with vomiting, bloating and anorexia. Oral protein supplements were not tolerated in dialysis patients and side effects resulted in high degree of non-compliance.