ESPEN 2022 Late Breaking Abstracts
Topic: Nutrition and chronic disease
Abstract Submission Identifier: ESPEN22-LB-2152
EFFECT ON NUTRITIONAL STATUS AND BIOMARKERS OF INFLAMMATION AND OXIDATION OF AN ORAL NUTRITIONAL SUPPLEMENT (WITH OR WITHOUT PROBIOTICS) IN MALNOURISHED HEMODIALYSIS PATIENTS. A MULTICENTER RANDOMIZED CLINICAL TRIAL “RENACARE TRIAL”.
G. Olveira*, 1, 2, F. Hevilla 1, M. Padial 1, M. Blanca 3, G. Barril 4, T. Jiménez-Salcedo 5, M. Ramírez Ortiz 6, Á. Nogueira 4, A. Gentile 1, V. Sasso 1
1Endocrinología y Nutrición, Hospital Regional Universitario de Málaga. IBIMA. , 2Medicine, Universidad de Málaga , Málaga, 3Nefrología, Hospital Juan Carlos 1 , 4Nefrología , Hospital la Princesa , Madrid, 5Nefrología , Hospital Regional Universitario de Málaga. IBIMA., Málaga, 6Endocrinología y Nutrición, Hospital la Princesa, Madrid, Spain
Rationale: Malnutrition in hemodialysis patients is frequent and it is associated with a reduction in muscular mass and strength with an increase in inflammatory and oxidative markers.
Methods: randomized, multicenter, parallel-group trial in Malnourished Hemodialysis Patients with 3 groups (1: Control -C- individualized diet 2: Oral nutritional supplement + placebo -SU-PL- and 3: Oral nutritional supplement + probiotics -SU-PR ); the trial was open to the intake of ONS or individualized diet recommendations, but double-blind to the intake of probiotics. We assessed at baseline and at 3 and 6 months anthropometric measurements, handgrip strength, SPPB, bioelectrical impedance analysis (BIA), dietary records, and routine biochemical parameters. Inflammation and oxidation biomarkers were determined using ELISA techniques (Versamax and ProcartaPlex multiplex Immunoassay). Results were analyzed by intention to treat.
Results: 31 patients (11 in group C, 11 in SU-PL- and 11 in SU-PR) completed the trial at 6 months. Both supplemented groups significantly increased energy, protein and fat (total monounsaturated and w3) and fiber intake. Weight, dry weight and fat free mass increased significantly in the supplemented groups at 3 and 6 m and dynamometry in SU-PL. Prealbumin and vitamin D increased significantly at 3 m in the SU-TOT group (sum of SU-PL+SU-PR). No changes were observed in the levels of phosphorus, potassium in any of the groups. Significant changes were observed in some biomarkers of inflammation in the groups supplemented during the intervention (BDNF, BMP2, MCP-1, IL1-beta, IL-10, IL-4, IL-8). Total antioxidant capacity (TAC) increased significantly in supplemented patients without finding significant changes in isoprostanes.
Conclusion: the specific oral nutritional supplement improved nutritional status, caloric-protein intake and some biomarkers of inflammation/oxidation, without finding clear differences depending on the addition of probiotics.
FUNDING: RTC-2017-5959-1 Ministry of Science, Innovation and Universities and FIS PI18/01041.
References: Ikizler, T. Alp, Noel J. Cano, Harold Franch, Denis Fouque, Jonathan Himmelfarb, Kamyar Kalantar-Zadeh, Martin K. Kuhlmann, et al. 2013. “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 International 84 (6): 1096–1107.
Disclosure of Interest: G. Olveira Grant / Research Support from: Adventia Pharma , F. Hevilla : None Declared, M. Padial : None Declared, M. Blanca: None Declared, G. Barril : None Declared, T. Jiménez-Salcedo: None Declared, M. Ramírez Ortiz : None Declared, Á. Nogueira: None Declared, A. Gentile : None Declared, V. Sasso: None Declared
Keywords: Haemodialysis, Inflamation, oral nutritional supplement, oxidative stress