Can oral supplementation with a collagen-casein based hydrolyzed liquid protein improve serum albumin levels in hypoalbuminemic hemodialysis patients?

Dialysis and Transplatation: v 36: No 5 2007: 258-265
Ann Pittaoulis, RD and Evelyn Phillips, MS, RD, LDN

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ABSTRACT

Background: Decreased albumin (ALB) synthesis results in hypoalbuminemia and occurs due to the interrelationship of inflammation and malnutrition (uremic malnutrition) observed in chronic hemodialysis (CHD) patients. Improving the nutritional status of CHD patients is necessary to prevent and treat
uremic malnutrition. The issue remains in how to achieve this goal in CHD patients given the barriers to adequate and appropriate intake such as anorexia, dietary restrictions and impaired nutrient absorption.

Objective: To determine if oral supplementation with a collagen-casein based hydrolyzed liquid protein can improve ALB in hypoalbuminemic CHD patients.

Subjects: Adult CHD outpatients with serum ALB ≥ 2.8 g/dL and ≤ 3.7 g/dL with given written consent. Intervention: Subjects (age = 31-90y) were divided into 2 groups based on days of dialysis. Controls (n=21; dialysis days TThSat) received standard nutritional counseling. Study group (n=29; dialysis days MWF) received 30 mg of liquid protein one hour into and 15 minutes before the end of treatment. Main outcome measures: Baseline and monthly ALB for 3 months. Subjective assessment of adverse events.

Results: In the control group, 5 subjects did not complete the study (final n=16 [49%]) and 12 subjects in the study group, (final n=17 [51%]). There was not a statistically significant correlation between baseline ALB and baseline CRP, r- -0.30 (P-0.093) or between baselines ALB and baseline URR, r- 0.27
(P=0.14). There was no difference in the average ALB between baseline (3.43) and final (3.44 g/dL) for the control group, t= -0.54; df=15; P-0.60. In the study group, the final average (SD) ALB (3.73 [0.28]) was statistically significantly greater than baseline (3.49[0.20]), t= -4.19; df=16; P=0.001.

Conclusion: These statistically significant results indicate that oral supplementation with a collagen-casein based hydrolyzed liquid protein can improve serum albumin levels in hypoalbuminemic CHD patients.