Malnourished patients with end-stage renal disease who take oral nutritional supplements (ONS) during hemodialysis (HD) sessions have improved survival and are less likely to be hospitalized, according to findings presented at the World Renal Nutrition Week in Honolulu.
In an observational study of 21,117 malnourished HD patients (serum albumin levels 3.5 g/dL or less), Eduardo Lacson, Jr., MD, MPH, and colleagues at Fresenius Medical Care North America (FMCNA) in Waltham, Mass., compared 7,264 who received monitored ONS (at no cost to them) during HD sessions and 13,853 who did not (controls). Patients were offered two protein bars and two liquid formulations of ONS until albumin levels were 4.0 g/dL or higher. The use of intradialytic ONS is part of a standardized national program at FMCNA facilities.
After adjusting for baseline case mix and five HD quality indicators, ONS patients had a 32% decreased risk of death. The number of hospitalization events from all causes (HOS) were significantly lower in the ONS group than the controls (2.5 vs. 2.7 episodes/patient/year), after additional adjustment for HOS 30 days prior to study entry.