Intradialytic High Protein Meals May Correct Low Albumin

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ORLANDO, Fla.—Having hemodialysis (HD) patients eat high protein meals during dialysis sessions may offer a way to correct abnormally low albumin levels, according to findings presented at the National Kidney Foundation's Spring Clinical Meetings. This approach involves the concomitant use of a phosphate binder to control phosphorus levels.

In a study of 110 hypoalbuminemia HD patients (serum albumin levels below 4 mg/dL), significantly more patients treated with this novel approach experienced a rise in serum albumin greater than 0.2 g/dL while maintaining target phosphorus levels compared with a control arm (25.5% vs. 9.8%). Phosphorus levels had to be at least 3.5 but less than 5.5 mg/dL.

The investigators, led by Kamyar Kalantar-Zadeh, MD, MPH, PhD, of the University of California Irvine Medical Center, observed no serious adverse events and patients reported satisfaction with high protein meals during HD.

Dr. Kalantar-Zadeh's group noted that the traditional approach of restricting protein to control phosphorus in dialysis patients may not be the most appropriate method, especially hypoalbuminemia dialysis patients.

For the study, the researchers randomly assigned patients to an intervention arm or a control arm. Patients in the intervention arm received eight weeks of high protein food in the form of cold meal boxes during each HD treatment, along with 0.5-1.5 g lanthanum carbonate (Fosrenol).

The meal boxes contained 51 g of protein, 850 calories, and a phosphorus-to-protein ratio less than 10 mg/g. Patients in the control arm received salad meal boxes containing less than 50 calories and less than 1 g of protein during each HD treatment and continued lanthanum carbonate as needed.

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