The impact of predialytic oral protein-based supplements on nutritional status and quality of life in hemodialysis patients: a randomized clinical trial

Abstract Background Administration of oral nutritional supplements (ONS) inside hemodialysis (HD) units before sessions is an increasingly adopted option. Our aim was to assess the effects of predialytic ONS on nutritional status and quality of life (QOL) in HD patients. Methods One hundred HD patie...

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Main Authors: Mohamed Mamdouh Elsayed, Mohamed Magdy Abdelkader, Amr Mohamed ElKazaz, Iman Ezzat Elgohary
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Nephrology
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Online Access:https://doi.org/10.1186/s12882-025-03999-3
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author Mohamed Mamdouh Elsayed
Mohamed Magdy Abdelkader
Amr Mohamed ElKazaz
Iman Ezzat Elgohary
author_facet Mohamed Mamdouh Elsayed
Mohamed Magdy Abdelkader
Amr Mohamed ElKazaz
Iman Ezzat Elgohary
author_sort Mohamed Mamdouh Elsayed
collection DOAJ
description Abstract Background Administration of oral nutritional supplements (ONS) inside hemodialysis (HD) units before sessions is an increasingly adopted option. Our aim was to assess the effects of predialytic ONS on nutritional status and quality of life (QOL) in HD patients. Methods One hundred HD patients were enrolled in this prospective, multicentric randomized clinical trial. Patients were assigned to receive ONS (25 gm protein powder) 1 h prior to the start of the HD session (predialytic) or maintained on their routine nutrition regimen for 3 months. Results At study end, supplemented patients showed a significant increase in serum albumin (p < 0.001), and a non-significant decrease in the median subjective global assessment (SGA) score. While in the control group, serum albumin remained stable, and the median SGA score increased significantly (p < 0.001). Body mass index and anthropometric measures did not differ between both groups. The supplemented patients showed significant improvement in three subscales of the Kidney Disease Quality of Life-36, without a significant change in QOL in control patients. Supplemented patients had significantly higher blood pressure (BP) (p = 0.037), lower urea reduction ratio (p = 0.020) and Kt/V (p = 0.021), higher serum calcium, lower total cholesterol and lower CRP (p = 0.047) levels compared to controls. There was no significant difference between groups regarding serum sodium, potassium, or phosphorus or adverse events. Conclusions Predialytic ONS administration may contribute to improvements in serum albumin, and QOL. The effects on BP, CRP, and the reduction in dialysis adequacy, should be carefully considered while adopting such strategy. Clinical trials registration ClinicalTrials.gov NCT05952570. First registration date 2/07/2023.
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spelling doaj-art-acf6dedd8484497abdcde841209287dc2025-08-20T02:16:45ZengBMCBMC Nephrology1471-23692025-02-012611910.1186/s12882-025-03999-3The impact of predialytic oral protein-based supplements on nutritional status and quality of life in hemodialysis patients: a randomized clinical trialMohamed Mamdouh Elsayed0Mohamed Magdy Abdelkader1Amr Mohamed ElKazaz2Iman Ezzat Elgohary3Nephrology and Internal Medicine Department, Faculty of Medicine, Alexandria UniversityNephrology and Internal Medicine Department, Faculty of Medicine, Alexandria UniversityInternal Medicine Department, El Qabbary General Hospital, Ministry of HealthNephrology and Internal Medicine Department, Faculty of Medicine, Alexandria UniversityAbstract Background Administration of oral nutritional supplements (ONS) inside hemodialysis (HD) units before sessions is an increasingly adopted option. Our aim was to assess the effects of predialytic ONS on nutritional status and quality of life (QOL) in HD patients. Methods One hundred HD patients were enrolled in this prospective, multicentric randomized clinical trial. Patients were assigned to receive ONS (25 gm protein powder) 1 h prior to the start of the HD session (predialytic) or maintained on their routine nutrition regimen for 3 months. Results At study end, supplemented patients showed a significant increase in serum albumin (p < 0.001), and a non-significant decrease in the median subjective global assessment (SGA) score. While in the control group, serum albumin remained stable, and the median SGA score increased significantly (p < 0.001). Body mass index and anthropometric measures did not differ between both groups. The supplemented patients showed significant improvement in three subscales of the Kidney Disease Quality of Life-36, without a significant change in QOL in control patients. Supplemented patients had significantly higher blood pressure (BP) (p = 0.037), lower urea reduction ratio (p = 0.020) and Kt/V (p = 0.021), higher serum calcium, lower total cholesterol and lower CRP (p = 0.047) levels compared to controls. There was no significant difference between groups regarding serum sodium, potassium, or phosphorus or adverse events. Conclusions Predialytic ONS administration may contribute to improvements in serum albumin, and QOL. The effects on BP, CRP, and the reduction in dialysis adequacy, should be carefully considered while adopting such strategy. Clinical trials registration ClinicalTrials.gov NCT05952570. First registration date 2/07/2023.https://doi.org/10.1186/s12882-025-03999-3PredialysisProtein supplementationNutritionQuality of lifeHemodialysis
spellingShingle Mohamed Mamdouh Elsayed
Mohamed Magdy Abdelkader
Amr Mohamed ElKazaz
Iman Ezzat Elgohary
The impact of predialytic oral protein-based supplements on nutritional status and quality of life in hemodialysis patients: a randomized clinical trial
BMC Nephrology
Predialysis
Protein supplementation
Nutrition
Quality of life
Hemodialysis
title The impact of predialytic oral protein-based supplements on nutritional status and quality of life in hemodialysis patients: a randomized clinical trial
title_full The impact of predialytic oral protein-based supplements on nutritional status and quality of life in hemodialysis patients: a randomized clinical trial
title_fullStr The impact of predialytic oral protein-based supplements on nutritional status and quality of life in hemodialysis patients: a randomized clinical trial
title_full_unstemmed The impact of predialytic oral protein-based supplements on nutritional status and quality of life in hemodialysis patients: a randomized clinical trial
title_short The impact of predialytic oral protein-based supplements on nutritional status and quality of life in hemodialysis patients: a randomized clinical trial
title_sort impact of predialytic oral protein based supplements on nutritional status and quality of life in hemodialysis patients a randomized clinical trial
topic Predialysis
Protein supplementation
Nutrition
Quality of life
Hemodialysis
url https://doi.org/10.1186/s12882-025-03999-3
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