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Study aim
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To determine the effect of improving nutritional status on the response of hemodialysis patients to erythropoietin therapy, we conducted a study to determine whether correction of malnutrition could reduce the need for high doses of erythropoietin-stimulating agents (ESAs), improve anemia, and improve patients' quality of life.
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Design
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All eligible subjects will be randomly assigned to one of two groups, either supplement or control, in a 1:1 ratio. The randomization method will be permuted block randomization. Sample size = 50
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Settings and conduct
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In the intervention group, 25 patients will use vm protein powder for three months as prescribed and under the supervision of a nutritionist and nephrologist. 25 patients in the control group will continue their routine diet. For both groups before and after the intervention, erythropoietin resistance index, serum erythropoietin levels, ferritin, hemoglobin, CRP, nutritional status and prevalence of PEW will be measured based on MUST scales and body composition analysis with the InBody S10 device.
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Participants/Inclusion and exclusion criteria
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Inclusion criteria:
Patients with chronic kidney disease undergoing chronic hemodialysis for at least 6 months.
Diagnosis of PEW according to international criteria
weight loss ≥ 5% in the last 3 monthsor BMI<23
Reduced muscle mass based on BIA measurement
Reduced serum albumin or reduced serum TIBC level
Reduced energy and protein intake
Written consent to participate in the study
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Intervention groups
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In the intervention group, 25 patients used VM protein powder for three months as prescribed and under the supervision of a nutritionist and nephrologist.
In the control group, 25 patients will enter the study without any changes in their diet and lifestyle.
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Main outcome variables
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serum erythropoietin, erythropoietin resistance index, erythropoietin dose, hemoglobin levels, Esr,Crp