Effect of an oral amino acid supplement on nutritional and inflammatory parameters in hemodialysis patients.

Abstract

Introduction: Protein-energy wasting (PEW) and chronic inflammation significantly increase morbidity and mortality in hemodialysis (HD) patients. This study evaluates the clinical impact of oral supplementation with a specific amino acid solution (RENORAL®, 150 mL; 13 g of protein per session) over 6 months on body composition, inflammatory biomarkers, functional capacity, and quality of life (QoL).

Materials and methods: A prospective, randomized, controlled 6-month study involving 40 chronic HD patients, divided into two arms: the Renoral® group (n = 20) and the control group (n = 20). Clinical and laboratory assessments were performed at baseline and at months 3 and 6. Primary variables analyzed were lean body mass, handgrip strength, and C-reactive protein (CRP); secondary variables included serum albumin, weekly erythropoietin (EPO) dose, dialysis adequacy (Kt/V), and QoL scores.

Results: After 6 months, the Renoral® group showed statistically significant improvements compared to baseline and the control group (p < 0.05): lean mass increased from 18.65 kg to 20.37 kg (+9%; p < 0.05), fat mass decreased (6.82 kg to 5.22 kg), handgrip strength improved (+18%; p < 0.05), and CRP decreased (10.19 mg/L to 6.22 mg/L; p < 0.05), whereas it increased in the control group (4.38 mg/L to 7.64 mg/L). QoL improved significantly in the Renoral® group (92.55 to 95.61; p < 0.05) compared to the control group (89.83 to 91.44), with a reduction in the erythropoietin dose at 3 months in the intervention group (3520 IU to 3300 IU).

Conclusions: Nutritional supplementation with Renoral® for 6 months reduces systemic inflammation and PEW, optimizing muscle mass, functional strength, and quality of life in patients undergoing chronic hemodialysis, thereby serving as an effective intervention to improve prognostic indicators.