Effect of a high protein tuna snack on nutritional status and its suitability for renal replacement therapy patients
Keywords:
tuna snack, dialysis, malnutritionAbstract
This study aimed to evaluate the effect of a high-protein tuna snack, containing 10 g of protein and controlled sodium, potassium and phosphorus composition, on the nutritional status of patients in renal replacement therapy (RRT). Nutrition-related parameters were compared at baseline and after four weeks of daily supplementation. A total of 170 patients undergoing dialysis were divided into two groups based on their mode of dialysis: 90 patients in the hemodialysis (HD) group and 80 patients in the peritoneal dialysis (PD) group. At the end of the study, serum prealbumin levels significantly increased in both groups (HD 33.20 ± 8.24 to 35.09 ± 8.13 mg/dL, P = 0.027; PD 36.76 ± 9.17 to 39.00 ± 9.84 mg/dL, P = 0.002). Additionally, the total iron binding capacity (TIBC) significantly increased in the PD group (222.82 ± 42.43 to 232.66 ± 48.66 mcg/dL; P = 0.001). The daily energy and protein intake were also significantly increased among all participants (1143.75 ± 330.67 to 1264.72 ± 354.18 kcal/day, P < 0.001 and 49.33 ± 15.65 to 58.93 ± 17.43 g/day, P < 0.001, respectively). However, no statistically significant changes were noted in serum albumin, body weight, MIS score, serum sodium, potassium and phosphorus levels. In conclusion, a high-protein tuna snack can constitute an alternative protein source for the patient in RRT. It might improve serum prealbumin levels without causing adverse events.
References
Tantivess S, Werayingyong P, Chuengsaman P, Teerawattananon Y. Universal coverage of renal dialysis in Thailand: promise, progress, and prospects. BMJ. 2013;346:f462.
Praditpornsilpa K, Lekhyananda S, Premasathian N, Kingwatanakul P, Lumpaopong A, Gojaseni P, et al. Prevalence trend of renal replacement therapy in Thailand: impact of health economics policy. J Med Assoc Thai. 2011;94 Suppl 4:S1-6.
de Mutsert R, Grootendorst DC, Axelsson J, Boeschoten EW, Krediet RT, Dekker FW, et al. Excess mortality due to interaction between protein-energy wasting, inflammation and cardiovascular disease in chronic dialysis patients. Nephrol Dial Transplant. 2008;23(9):2957-64.
Kittiskulnam P, Chuengsaman P, Kanjanabuch T, Katesomboon S, Tungsanga S, Tiskajornsiri K, et al. Protein-energy wasting and mortality risk prediction among peritoneal dialysis patients. J Ren Nutr. 2021;31(6):679-86.
Ikizler TA, Burrowes JD, Byham-Gray LD, Campbell KL, Carrero JJ, Chan W, et al. KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update. Am J Kidney Dis. 2020;76(3 Suppl 1):S1-S107.
Prelevic V, Antunovic T, Radunovic D, Gligorovic-Barhanovic N, Gledovic B, Ratkovic M, et al. Malnutrition inflammation score (MIS) is stronger predictor of mortality in hemodialysis patients than waist-to-hip ratio (WHR)-4-year follow-up. Int Urol Nephrol. 2022;54(3):695-700.
Brandao da Cunha Bandeira S, Cansancao K, Pereira de Paula T, Peres WAF. Evaluation of the prognostic significance of the malnutrition inflammation score in hemodialysis patients. Clin Nutr ESPEN. 2020;35:109-15.
Rambod M, Bross R, Zitterkoph J, Benner D, Pithia J, Colman S, et al. Association of malnutrition-inflammation score with quality of life and mortality in hemodialysis patients: a 5-year prospective cohort study. Am J Kidney Dis. 2009;53(2):298-309.
Sa Martins V, Adragao T, Aguiar L, Pinto I, Dias C, Figueiredo R, et al. Prognostic value of the malnutrition-inflammation score in hospitalization and mortality on long-term hemodialysis. J Ren Nutr. 2022;32(5):569-77.
Ikeda-Taniguchi M, Takahashi K, Shishido K, Honda H. Total iron binding capacity is a predictor for muscle loss in maintenance hemodialysis patients. Clin Exp Nephrol. 2022;26(6):583-92.
Bross R, Zitterkoph J, Pithia J, Benner D, Rambod M, Kovesdy CP, et al. Association of serum total iron-binding capacity and its changes over time with nutritional and clinical outcomes in hemodialysis patients. Am J Nephrol. 2009;29(6):571-81.
Smith SH. Using albumin and prealbumin to assess nutritional status. Nursing. 2017;47(4):65-6.
Lee KH, Cho JH, Kwon O, Kim SU, Kim RH, Cho YW, et al. Low prealbumin levels are independently associated with higher mortality in patients on peritoneal dialysis. Kidney Res Clin Pract. 2016;35(3):169-75.
Ikizler TA. Using and interpreting serum albumin and prealbumin as nutritional markers in patients on chronic dialysis. Semin Dial. 2014;27(6):590-2.
Sreedhara R, Avram MM, Blanco M, Batish R, Avram MM, Mittman N. Prealbumin is the best nutritional predictor of survival in hemodialysis and peritoneal dialysis. Am J Kidney Dis. 1996;28(6):937-42.
Mittman N, Avram MM, Oo KK, Chattopadhyay J. Serum prealbumin predicts survival in hemodialysis and peritoneal dialysis: 10 years of prospective observation. Am J Kidney Dis. 2001;38(6):1358-64.
Pasticci F, Fantuzzi AL, Pegoraro M, McCann M, Bedogni G. Nutritional management of stage 5 chronic kidney disease. J Ren Care. 2012;38(1):50-8.
Jiwakanon S, Warodomwichit, D., Supasyndh, O., Chattranukulchai, P., Pitprasert, V., Nongnuch, A. et al. Clinical practice recommendations for nutritional management in adult kidney patients 2018. Thai JPEN. 2020;28(2):18-67.
Fouque D, Kalantar-Zadeh K, Kopple J, Cano N, Chauveau P, Cuppari L, et al. A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease. Kidney Int. 2008;73(4):391-8.
Kaplan AA, Halley SE, Lapkin RA, Graeber CW. Dialysate protein losses with bleach processed polysulphone dialyzers. Kidney Int. 1995;47(2):573-8.
Murtas S, Aquilani R, Deiana ML, Iadarola P, Secci R, Cadeddu M, et al. Differences in amino acid loss between high-efficiency hemodialysis and postdilution and predilution hemodiafiltration using high convection volume exchange-A new metabolic scenario? A Pilot Study. J Ren Nutr. 2019;29(2):126-35.
Gil HW, Yang JO, Lee EY, Lee EM, Choi JS, Hong SY. The effect of dialysis membrane flux on amino acid loss in hemodialysis patients. J Korean Med Sci. 2007;22(4):598-603.
Young GA, Brownjohn AM, Parsons FM. Protein losses in patients receiving continuous ambulatory peritoneal dialysis. Nephron. 1987;45(3):196-201.
Westra WM, Kopple JD, Krediet RT, Appell M, Mehrotra R. Dietary protein requirements and dialysate protein losses in chronic peritoneal dialysis patients. Perit Dial Int. 2007;27(2):192-5.
Rodriguez-Garcia VH, Lopez-Guerra EA, Rodriguez-Castellanos FE. Association between peritoneal protein excretion, peritonitis and D/P phosphate, in patients on peritoneal dialysis. Nefrologia. 2013;33(2):204-13.
Sabatino A, Regolisti G, Karupaiah T, Sahathevan S, Sadu Singh BK, Khor BH, et al. Protein-energy wasting and nutritional supplementation in patients with end-stage renal disease on hemodialysis. Clin Nutr. 2017;36(3):663-71.
Jankowska M, Rudnicki-Velasquez P, Storoniak H, Rutkowski P, Rutkowski B, Krzyminski K, et al. Thiamine diphosphate status and dialysis-related losses in end-stage kidney disease patients treated with hemodialysis. Blood Purif. 2017;44(4):294-300.
Blumberg A, Hanck A, Sander G. Vitamin nutrition in patients on continuous ambulatory peritoneal dialysis (CAPD). Clin Nephrol. 1983;20(5):244-50.
Limwannata P, Satirapoj B, Chotsriluecha S, Thimachai P, Supasyndh O. Effectiveness of renal-specific oral nutritional supplements compared with diet counseling in malnourished hemodialysis patients. Int Urol Nephrol. 2021;53(8):1675-87.
Ikizler TA, Cano NJ, Franch H, Fouque D, Himmelfarb J, Kalantar-Zadeh K, et al. Prevention and treatment of protein energy wasting in chronic kidney disease patients: a consensus statement by the International Society of Renal Nutrition and Metabolism. Kidney Int. 2013;84(6):1096-107.
Wichchukit S, O’Mahony M. The 9-point hedonic scale and hedonic ranking in food science: some reappraisals and alternatives. J Sci Food Agric. 2015;95(11):2167-78.
Rambod M, Kovesdy CP, Bross R, Kopple JD, Kalantar-Zadeh K. Association of serum prealbumin and its changes over time with clinical outcomes and survival in patients receiving hemodialysis. Am J Clin Nutr. 2008;88(6):1485-94.
Moretti HD, Johnson AM, Keeling-Hathaway TJ. Effects of protein supplementation in chronic hemodialysis and peritoneal dialysis patients. J Ren Nutr. 2009;19(4):298-303.
Mah JY, Choy SW, Roberts MA, Desai AM, Corken M, Gwini SM, et al. Oral protein-based supplements versus placebo or no treatment for people with chronic kidney disease requiring dialysis. Cochrane Database Syst Rev. 2020;5(5):CD012616.
Lee SW, Yang YM, Kim HY, Cho H, Nam SW, Kim SM, et al. Predialysis urea nitrogen is a nutritional marker of hemodialysis patients. Chonnam Med J. 2022;58(2):69-74.
Yildiz A, Tufan F. Lower creatinine as a marker of malnutrition and lower muscle mass in hemodialysis patients. Clin Interv Aging. 2015;10:1593.
Fouque D, McKenzie J, de Mutsert R, Azar R, Teta D, Plauth M, 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. 2008;23(9):2902-10.
Shinaberger CS, Kilpatrick RD, Regidor DL, McAllister CJ, Greenland S, Kopple JD, et al. Longitudinal associations between dietary protein intake and survival in hemodialysis patients. Am J Kidney Dis. 2006;48(1):37-49.
Jontosohn R, Junkers K, Muller H, Heinze V, Kluthe R. [Serum transferrin, protein intake, and iron metabolism in regular hemodialysis patients (author’s transl)]. Klin Wochenschr. 1974;52(8):398-9.
Allman MA, Stewart PM, Tiller DJ, Horvath JS, Duggin GG, Truswell AS. Energy supplementation and the nutritional status of hemodialysis patients. Am J Clin Nutr. 1990;51(4):558-62.
Tietze IN, Pedersen EB. Effect of fish protein supplementation on aminoacid profile and nutritional status in haemodialysis patients. Nephrol Dial Transplant. 1991;6(12):948-54.
Sahathevan S, Karupaiah T, Khor BH, Sadu Singh BK, Mat Daud ZA, Fiaccadori E, et al. Muscle status response to oral nutritional supplementation in hemodialysis patients with protein energy wasting: A Multi-Center Randomized, Open Label-Controlled Trial. Front Nutr. 2021;8:743324.
Scialla JJ, Anderson CA. Dietary acid load: a novel nutritional target in chronic kidney disease?. Adv Chronic Kidney Dis. 2013;20(2):141-9.
Chang TI, Oh HJ, Kang EW, Yoo TH, Shin SK, Kang SW, et al. A low serum bicarbonate concentration as a risk factor for mortality in peritoneal dialysis patients. PLoS One. 2013;8(12):e82912.
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