The Effect of Oral Nutritional Supplement in Malnourished CAPD Patients

Lee, In Hee; Kang, Shin Wook; Noh, Hyun Jin; Shin, Sug Kyun; Choi, Kyu Hun; Ha, Sung Kyu; Lee, Ho Yung; Han, Dae Suk; Lee, Seung Min; Cho, Eun Young; Lee, Jong Ho

Abstract

Protein-calorie malnutrition is common in CAPD patients and is associated with increased morbidity and mortality. To evaluate the effect of an oral nutritional supplement(Greenbia RDplus, DR. CHUNG'S FOOD CO., LTD, Seoul, Korea) providing 800Cal and 24g of protein daily in addition to their usual diet on the nutritional status, we conducted a prospective study in malnourished CAPD patients (N=26). Subjects were randomised into 2 groups: group I(N=15) taking Greenbia RDplus for 3 months, group II(N=11) as control. In group I, the data of 12 patients who completed the 3-months study period were analyzed. There were no statistically significant changes in biochemical parameters including total protein, serum albumin, prealbumin, transferrin during the study period in both groups, but IGF-I increased significantly in group I(129.2+/-88.8 vs. 174.1+/-109.3ng/mL, P<0.05). Total calorie (1349+/-272 vs. 1720+/-251Cal/day, P<0.05) and protein intake(1.05+/-0.29 vs. 1.24+/-0.25g/kg/day, P<0.05) assessed by 72-hours dietary recall method increased significantly in group I with oral supplement. Body weight(52.4+/-8.3 vs. 54.2+/-8.8kg, P<0.05), body mass index(18.7+/-1.8 vs. 19.5+/-2.0kg/m2, P<0.05), % body fat(13.2+/-4.2 vs. 15.4+/-3.9%, P<0.05), total body muscle(16.8+/-3.7 vs. 18.2+/-3.3kg, P<0.05), midarm circumference(22.8+/-2.1 vs. 23.7+/-2.2cm, P<0.05) and calculated arm muscle area(25.9+/-7.1 vs. 28.9+/-6.1 cm2, P<0.05) increased significantly in group I after 3 months. Biceps and triceps skinfold thickness tended to increase following oral nutritional supplement but there was no statistical significance. Anthropometric parameters remained unchanged in group II. Kt/Vurea, normalized protein catabolic rate and standardized creatinine clearance did not change in both groups. In conclusion, oral nutritional supplement in malnourished CAPD patients well tolerated and was effective in improving the anthropometric parameters.