Breaking News: A recent clinical trial suggests that supplementing hemodialysis patients with 25 grams of protein powder before each dialysis session can improve nutritional status adn quality of life, but also carries potential side effects like increased blood pressure.
A prospective, multicenter randomized controlled trial, published in BMC Nephrology in february 2025 (DOI: 10.1186/s12882-025-03211-x), investigated the effects of oral protein supplementation on 100 hemodialysis patients. Researchers, led by Dr. Mohamed M.Elsayed at Mansoura University Hospital in Egypt, divided participants into two groups: a supplementation group receiving 25 grams of protein powder one hour before each dialysis session, and a control group continuing their usual diet. The study duration was three months.
Results indicated a statistically significant increase in serum albumin concentration in the supplementation group compared to baseline (p < 0.001). However, the Median Subjective Global Assessment (SGA) score, a measure of nutritional status, showed a non-significant decrease, suggesting a potential worsening of perceived nutritional well-being. Conversely, the control group maintained stable serum albumin levels but experienced a significant increase in their SGA score (p < 0.001), indicating a decline in nutritional status.
Patients receiving the protein supplement reported significant improvements across three domains of the Kidney Disease Quality of Life-36 (KDQOL-36) questionnaire, while the control group showed no significant changes in quality of life.However, the supplementation group also exhibited higher blood pressure (p = 0.037), a lower urea reduction ratio (URR) (p = 0.020),and a lower single-pool Kt/V (p = 0.021) – both URR and Kt/V are measures of dialysis adequacy. Serum calcium levels where also substantially higher in the supplemented group (p = 0.017), while cholesterol levels were significantly lower (p = 0.022). No significant differences were observed between the groups regarding body mass index, anthropometry, or serum levels of sodium, potassium, or phosphate.
Context: Chronic kidney disease (CKD) frequently enough leads to malnutrition, contributing to increased morbidity and mortality in hemodialysis patients. Protein-energy wasting (PEW) is a common complication, and nutritional interventions are crucial. Hemodialysis,while life-sustaining,removes protein from the body,necessitating adequate dietary protein intake. The study highlights the complex interplay between nutritional supplementation, dialysis efficacy, and overall patient health. Further research is needed to optimize protein supplementation strategies, possibly adjusting dosage or timing, and to monitor for and manage potential adverse effects like hypertension. The Mansoura University hospital study adds to a growing body of evidence exploring the benefits and risks of nutritional interventions in this vulnerable patient population. The KDQOL-36 is a widely used instrument for assessing quality of life in patients with kidney disease, covering physical, emotional, and social well-being.
Source: Elsayed MM,Abdelkader MM,ElKazaz AM,et al. The impact of predialytic oral protein-based supplements on nutritional status and quality of life in hemodialysis patients: a randomized clinical trial. BMC Nephrol. 2025;26:103.
