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Comparison of the effects of two early intervention strategies on the health outcomes of malnourished hemodialysis patients

, : Comparison of the effects of two early intervention strategies on the health outcomes of malnourished hemodialysis patients. Journal of Renal Nutrition 11(3): 166-171

To determine the efficacy and cost-effectiveness of providing oral supplementation early in the course of malnutrition for hemodialysis (HD) patients. The study design consisted of 3 groups: an experimental group, a control group of patients with mild hypoalbuminemia (HA) (serum albumin [SA] = 3.5 to 3.7 g/dL), and a comparison group of patients with moderate to severe HA (SA = 2.5 to 3.4 g/dL). Ten outpatient hemodialysis centers in southeast lower Michigan. Treatment and control groups consisted of 32 HD patients with mild HA. Fourteen HD patients with moderate to severe HA comprised the comparison group. The experimental group received diet counseling and oral supplementation, and the control group received diet counseling only. The comparison group received physician-prescribed oral supplements and dietary counseling to permit comparison of the experimental treatment with current supplementation practices. Differences between groups in the number of patients reaching nutritional repletion, change in SA levels at the end of the study, and follow-up periods, were tested using chi-square analysis. Analysis of variance was used to compare group differences in treatment duration to repletion and number of hospitalization days. During the study period, significantly more patients reached nutritional repletion in the experimental group and control group (50% and 57%, respectively) than in the comparison group (7%). Overall, repletion occurred more quickly in the experimental group (3.2 +/- 1.7 months) than in the control group (3.5 +/- 1.2 months), with a larger number of patients in the experimental group repleted by month 2 of the study phase. During follow-up, patients in the experimental group were far more likely to maintain nutritional repletion or continue to improve (61%) than patients in the control group (14%). Although too few patients were hospitalized to show statistical significance, there was a trend toward greater numbers of hospital days in more malnourished patients (208 days for the comparison group), followed by those with mild HA who did not receive oral supplements (107 days), and the experimental group (71 days). Although the sample size for this study was too small for the results to be conclusive, it appears that use of nutritional supplements early in the course of malnutrition may provide benefits such as, attaining nutritional repletion more quickly, which results in less product usage. It is also more likely that good nutritional status will be maintained after supplementation is discontinued.


PMID: 11466668

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Bhat, M., 2007: Dentist as CEO. Journal of the American Dental Association 138(8): 1060,1062; Author Reply 1062-1060,1062; Author Reply 1062

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Kieffer, J.J., 1925: Deux genres nouveaux et plusieurs especes nouvelles du groupe des Orthocladiariae (Dipteres, Chironomides). Annales de la Societe Scientifique de Bruxelles, 44: 555-566

Brunar, M., 1958: Tympanoplasty with preservation of the auditory passage. Archiv für Ohren-, Nasen- und Kehlkopfheilkunde 173(2): 466-469

Nevissi A.E., 1984: Lead 210 and polonium 210 in Mount St. Helens ash. JGR Journal of Geophysical Research

Wang, J.Y., 1978: Temperature effect on the atmospheric transmission function in the 15-Mu m region. Optics Letters 2(6): 169-169

Chuah, S.Y.; Jayanthi, V.; Lee, C.N.; McDonald, B.; Probert, C.S.; Mayberry, J.F., 1992: Dietary fats and inflammatory bowel disease in Asians. Chemically processed, hydrogenated fats, such as margarine, have been implicated in the aetiology of inflammatory bowel disease. Toxic by-products may occur in their production or during frying and cooking. A survey of dietary oil usage was conduc...