Predialytic Oral Nutritional Supplement administration may improve serum albumin levels and QOL in dialysis patients: Study
Researchers have found in a new study that predialytic Oral Nutritional Supplement (ONS) administration may help improve serum albumin levels and quality of life (QOL) in dialysis patients. However, its effects on blood pressure (BP), C-reactive protein (CRP), and dialysis adequacy should be carefully evaluated before implementation. This study was published by BMC Nephrology by Mohamed E. and colleagues.
Malnutrition in patients with HD is widespread and results in worse health conditions as well as low QOL. ONS supplied within the dialysis settings have become one option for controlling such issues. This research sought to evaluate the impact of predialytic ONS on serum albumin, QOL, and other metabolic indices in HD patients.
100 HD patients were enrolled in this prospective, multicentric randomized clinical trial. The patients were randomly assigned into two groups: one group was given ONS with 25 g of protein powder one hour prior to their HD sessions, and the other group was given their usual routine nutritional regimen. The trial continued for three months, and the researchers measured serum albumin, body mass index (BMI), anthropometric measurements, subjective global assessment (SGA), QOL scores, blood pressure (BP), and several metabolic parameters.
Key Findings
ONS patients had a significant improvement in serum albumin levels (p < 0.001), while no changes were noted in the control group.
SGA score fell (improvement) in the ONS group, although this was not statistically significant. In contrast, the control group experienced a significant rise in SGA score (p < 0.001), reflecting a decline in nutritional status.
There were no statistically significant differences between groups in terms of BMI or anthropometric assessment.
Quality of Life (QOL) was enhanced in three Kidney Disease Quality of Life-36 subscales in the supplemented group, with no changes observed in the control group.
The ONS group presented increased blood pressure (p = 0.037) and decreased urea reduction ratio (p = 0.020) and Kt/V (p = 0.021), suggesting decreased dialysis adequacy.
Supplemented subjects had increased serum calcium, decreased total cholesterol, and decreased C-reactive protein (CRP) (p = 0.047) compared to the control group.
There were no differences between both groups for serum sodium, potassium, phosphorus, or for adverse effects.
The study authors concluded that predialytic ONS delivery could yield significant gains in serum albumin and QOL in HD patients. Its influence on blood pressure, dialysis adequacy, and inflammation must be weighed before routine use can be recommended. Further research must determine how to maximize supplementation regimens while minimizing associated risks.
Reference:
Elsayed, M.M., Abdelkader, M.M., ElKazaz, A.M. et al. The impact of predialytic oral protein-based supplements on nutritional status and quality of life in hemodialysis patients: a randomized clinical trial. BMC Nephrol 26, 103 (2025). https://doi.org/10.1186/s12882-025-03999-3
