Oral and parenteral essential amino acid therapy in malnourished hemodialysis patients

Background/Aims. Malnutrition has been encountered more frequently than, ex pected and is, associated with increased morbidity and mortality in hemodia lysis (HD) patients. Until the last few years, only oral and enteral nutrit ional supplies, have been, used in the, treatment of malnutrition in HD pat ients. However, intradialytic parenteral essential amino acid (EAA) nutriti on has recently been introduced to treat these patients. The present study was conducted to compare both methods of EAA nutrition, oral and parenteral , in malnourished HD patients, Methods. Half of the 20 malnourished HD pati ents in this study received 0.9 g/kg/week of oral EAA (oral group), while t he other half of the patients were treated with the same dose of parenteral EAA (parenteral group) for 4 months. However, at the very beginning of the study, 4 patients from the oral group were transferred to the parenteral g roup because of complaints Such as nausea and vomiting. Therefore, this stu dy was completed with 6 patients in the oral group and 14 patients in the p arenteral group. Some biochemical parameters, including blood lymphocyte co unts and anthropometric measurements as indicators of the nutritional statu s, were obtained from both of the groups in the pre- and posttreatment peri ods. Results: Following the treatment, there were no statistically signific ant differences between the groups with respect to anthropometric measureme nts. However, statistically significant increases were observed in serum al bumin (p = 0.048) and creatinine (p = 0.006) levels and blood lymphocyte co unts (p = 0.006) in the parenteral group, while there were statistically si gnificant increases only in serum calcium (p = 0.028) levels and blood lymp hocyte counts (p = 0.038) in the oral group following the treatment when co mpared to pretreatment values. Conclusion: These results show that parenter al EAA therapy is more comfortable and effective than oral EAA therapy in t he treatment of malnourished HD patients. Copyright (C) 2001 S, Karger AG, Basel.