NUTRITIONAL SUPPLEMENTATION IN DIALYSIS PATIENTS

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 在这项研究中，我们假设长期给予足够的透析内口服营养补充将增加尿毒症营养不良的慢性血液透析患者的内脏蛋白浓度和躯体蛋白储备。我们将通过一项随机、安慰剂对照的双盲研究，通过以下目的来检验这一假设。 目的1：长期给予透析内口服营养补充剂是否能改善营养不良的慢性血液透析患者的内脏蛋白浓度？ 这一特定目标的主要结果指标将是血清白蛋白浓度。血清白蛋白浓度取决于膳食营养素的摄入量。血清白蛋白浓度的变化与冠心病患者的住院和死亡风险密切相关。我们还将测量内脏蛋白浓度的其他标记物作为次要指标(血清前白蛋白、血清转铁蛋白)。 目的2：长期给予透析内口服营养补充剂是否能改善营养不良的慢性血液透析患者的体蛋白储备？ 这一特定目标的主要结果衡量标准是用双能X射线吸收法(DEXA)测量瘦体重。目前，DEXA提供了对冠心病患者瘦体重的最精确测量。我们还将使用身体蛋白质储存的其他测量作为次要结果测量(人体测量，通过生物电阻抗分析瘦体重)。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. In this study, we hypothesize that long-term administration of adequate intradialytic oral nutritional supplementation will increase visceral protein concentrations and somatic protein stores in chronic hemodialysis patients with uremic malnutrition. We will test this hypothesis by the following aims through a randomized, placebo-controlled, double-blinded study. Aim 1: Does long-term administration of intradialytic oral nutritional supplementation improve visceral protein concentrations in malnourished chronic hemodialysis patients? The primary outcome measure for this specific aim will be serum albumin concentration. Serum albumin concentration is dependent on dietary nutrient intake. Changes in serum albumin concentration are strongly associated with hospitalization and death risk in CHD patients. We will also measure additional markers of visceral protein concentrations as secondary outcome measures (serum prealbumin, serum transferrin). Aim 2: Does long-term administration of intradialytic oral nutritional supplementation improve somatic protein stores in malnourished chronic hemodialysis patients? The primary outcome measure for this specific aim is lean body mass measurement by dual-energy x-ray absorptiometry (DEXA). Currently, DEXA provides the most precise measure of lean body mass in CHD patients. We will also utilize other measures of somatic protein stores as secondary outcome measures (anthropometric measurements, lean body mass by bioelectrical impedance analysis).