Multinutrient oral supplements and tube feeding in maintenance dialysis: a systematic review and meta-analysis
Multinutrient oral supplements and tube feeding in maintenance dialysis: a systematic review and meta-analysis
Background:
This systematic review aims to determine the potential benefits of enteral multinutrient support (oral or tube) in patients with chronic kidney disease (CKD) receiving maintenance dialysis.
Methods:
Studies of multinutrient oral supplements and enteral tube feeding that involved comparisons of nutritional support versus routine care (ie, usual diet), disease-specific formulae (with adapted macronutrient and micronutrient composition for use in maintenance dialysis patients) versus standard formulae, and enteral tube feeding versus parenteral nutrition are included in this review. The outcome measures sought were clinical (quality of life, complications, and mortality), biochemical (albumin and electrolyte levels), and nutritional (dietary intake and anthropometry). Meta-analyses were performed when possible.
Results:
This review of 18 studies (5 randomized controlled trials [RCTs], 13 non-RCTs) suggests that enteral nutritional support increased total (energy and protein) intake and increased serum albumin concentration by 0.23 g/dL (2.3 g/L; 95% confidence interval, 0.037 to 0.418 g/dL [0.37 to 4.18 g/L]; 1 RCT, 2 non-RCTs), with little effect on electrolyte status (serum phosphate and potassium). Few studies reported clinical outcome, and there was insufficient information to compare disease-specific versus standard formulae or enteral versus parenteral nutrition.
Conclusion:
This systematic review suggests that enteral multinutrient support significantly increases serum albumin concentrations and improves total dietary intake. This may improve clinical outcome, especially in malnourished patients, but insufficient published data exist to examine this. Additional research is required to investigate clinical, economic, and nutritional consequences of using oral supplements and tube feeding (using standard or disease-specific feeds) in patients with CKD receiving maintenance dialysis.
meta-analysis, supplement, enteral, formula, chronic renal failure, dialysis, nutrition, nephrology
387-405
Stratton, Rebecca J.
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Bircher, Gemma
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Fouque, Denis
958fc027-cd89-485d-ab1f-6b4a85c90600
Stenvinkel, Peter
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De Mutsert, Renee
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Engfer, Meike
4f691076-d149-4c30-8068-88825cee6fa2
Elia, Marinos
964bf436-e623-46d6-bc3f-5dd04c9ef4c1
2005
Stratton, Rebecca J.
c6a5ead1-3387-42e7-8bea-5ac7d969d87b
Bircher, Gemma
de8e1dac-3345-4cac-b2de-d7d91380d0ca
Fouque, Denis
958fc027-cd89-485d-ab1f-6b4a85c90600
Stenvinkel, Peter
2dc04f7f-fbe3-476e-9bb0-404ca75435b8
De Mutsert, Renee
26a4f95b-acf6-4efd-9e5b-5280e9856161
Engfer, Meike
4f691076-d149-4c30-8068-88825cee6fa2
Elia, Marinos
964bf436-e623-46d6-bc3f-5dd04c9ef4c1
Stratton, Rebecca J., Bircher, Gemma, Fouque, Denis, Stenvinkel, Peter, De Mutsert, Renee, Engfer, Meike and Elia, Marinos
(2005)
Multinutrient oral supplements and tube feeding in maintenance dialysis: a systematic review and meta-analysis.
American Journal of Kidney Diseases, 46 (3), .
(doi:10.1053/j.ajkd.2005.04.036).
Abstract
Background:
This systematic review aims to determine the potential benefits of enteral multinutrient support (oral or tube) in patients with chronic kidney disease (CKD) receiving maintenance dialysis.
Methods:
Studies of multinutrient oral supplements and enteral tube feeding that involved comparisons of nutritional support versus routine care (ie, usual diet), disease-specific formulae (with adapted macronutrient and micronutrient composition for use in maintenance dialysis patients) versus standard formulae, and enteral tube feeding versus parenteral nutrition are included in this review. The outcome measures sought were clinical (quality of life, complications, and mortality), biochemical (albumin and electrolyte levels), and nutritional (dietary intake and anthropometry). Meta-analyses were performed when possible.
Results:
This review of 18 studies (5 randomized controlled trials [RCTs], 13 non-RCTs) suggests that enteral nutritional support increased total (energy and protein) intake and increased serum albumin concentration by 0.23 g/dL (2.3 g/L; 95% confidence interval, 0.037 to 0.418 g/dL [0.37 to 4.18 g/L]; 1 RCT, 2 non-RCTs), with little effect on electrolyte status (serum phosphate and potassium). Few studies reported clinical outcome, and there was insufficient information to compare disease-specific versus standard formulae or enteral versus parenteral nutrition.
Conclusion:
This systematic review suggests that enteral multinutrient support significantly increases serum albumin concentrations and improves total dietary intake. This may improve clinical outcome, especially in malnourished patients, but insufficient published data exist to examine this. Additional research is required to investigate clinical, economic, and nutritional consequences of using oral supplements and tube feeding (using standard or disease-specific feeds) in patients with CKD receiving maintenance dialysis.
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More information
Published date: 2005
Keywords:
meta-analysis, supplement, enteral, formula, chronic renal failure, dialysis, nutrition, nephrology
Identifiers
Local EPrints ID: 26000
URI: http://eprints.soton.ac.uk/id/eprint/26000
ISSN: 0272-6386
PURE UUID: 46098383-8c10-41d5-a314-32a32ebaf3e1
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Date deposited: 06 Apr 2006
Last modified: 15 Mar 2024 07:07
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Contributors
Author:
Rebecca J. Stratton
Author:
Gemma Bircher
Author:
Denis Fouque
Author:
Peter Stenvinkel
Author:
Renee De Mutsert
Author:
Meike Engfer
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