Effect Of Oral Nutrition Supplement On Nutritional Status In Maintenance Hemodialysis Patients

Objective:To study the efect of oral nutrition supplement on nutritional status in maintenance hemodialysis(MHD)patients.Methods:57 MHD patients with non-hospitalized maintenance hemodialysis who had been maintained for at least 3 months from the First Affiliated Hospital of Kunming Medical University and Yunnan Nephrology Hospital from February 2017 to August 2017,the Malnutrition innammation Score(MIS score)was used to test MHD patients'MICS,the patients with MICS were divided into mild(1?MICS?4)?moderate(5?MICS?8),severe group(MICS?9).Bioelectrie impedance analysis(BIA)method was employed to examine the muscle mass.and the laboratory index was used to assess the malnutrition of patients.On the basis of dietary survey,individualized nutrition education,dietary guidance,and encouragement exercise,oral nutritional supplement(enteral nutrition preparation made by the Clinical Nutrition Department of the First Affiliated Hospital)was given on the dialysis day for 3 months.To observe the change of the above indicators before and after nutrition intervention.Results:1.General information:57 cases of MHD patients were enrolled,37 cases are male(65%),20 cases were females(35%),and the average age(49.3±14.3).The primary disease:30 cases of chronic glomerulonephritis(52.6%),5 cases diabetic nephropathy(8.8%),8 cases of hypertensive nephropathy(14%),obstructive nephropathy in 1 case(1.8%),interstitial nephritis in 2 cases(3.5%),polycystic kidney in 2 cases(3.5%),9 cases of unknown causes(15.8%);2.Before oral nutrition supplement,there were 5 MICS mild groups,20 moderate cases,and 32 severe cases;After interventions:16 patients were in the mild MIC group,27 in the moderate group,and 14 in the severe group.After 3 months of nutritional supplementation,the degree of malnutrition-inflammatory syndrome improved,and there was a significant difference between the two groups before and after intervention(P<0.05);4.After oral nutrition supplement,the serum levels of IL-6 and TNF-a decreased(P<0.05);ALB and serum calcium increased(P<0.05).serum phosphorus decreased compared with those before treatment.The difference was statistically significant(P<0.05);5.The patients with oral nutritional supplements after 3 months,weight,skeletal muscle mass were significantly better than those before nutrition supplement(P<0.05).Conclusion:1.The prevalence of Malnutrition inflammation Complex Syndrome(MICS)in patients with MHD is 100%;2.Oral nutrition supplement can improve the degree of MICS in maintenance hemodialysis patients after 3 months;3.Oral nutrition supplement can effectively improve Serum albumin in patients with maintenance hemodialysis;4.Oral nutrition supplement can effectively increase the weight,skeletal muscle mass...