MO936: Oral Nutritional Supplementation Support in HAEmodialysis Patients: Impact on Nutritional Rehabilitation

Abstract BACKGROUND AND AIMS Nutritional status management and rehabilitation are significant concern treating maintenance haemodialysis (HD) patients. Oral nutritional supplements are essential to complement insufficient dietary intake, namely of energy and protein, and to rehabilitate a patient's nutritional status. Therefore, the objective of this preliminary study was to assess the impact of oral nutritional supplementation (ONS) prescription patterns on patients’ nutritional status. METHOD We did a cross-sectional analysis of HD patients’ first oral nutritional supplementation with commercial formulas between October 2018 and March 2020 in 25 outpatient HD clinics. The registered nutritionist dietitian decided to initiate, choosing the type of supplement and dose as part of a routine protocol of a comprehensive nutritional intervention and assessment. We assessed albumin, normalized protein catabolic rate, potassium and phosphate at the beginning (t = 0) and end (t = 1) of the supplementation period to understand the nutritional impact. We also estimated the daily proportion of energy, and protein contribution of each oral nutritional supplementation implemented, categorizing in cut-offs of 100 kcal and 5 g of protein. RESULTS We analyzed 398 patients, 217 (54.5%) males, 165 (41.5%) diabetic, with a median age of 79 years. Concerning feeding support status, 24.6% were autonomous, 54.8% had family care and 20.6% were institutionalized.   Globally, the ONS impact was significant in the increment of albumin (P < 0.001) and nPCR (P = 0.002), although nPCR was not significant in the categorized group providing <5 g of protein/day (Table 2). The increment of K was also significant (P < 0.001) but not clinically relevant in increasing the risk of hyperkalaemia. There was no significant difference in P (P = 0.086). CONCLUSION ONS significantly impacted nutritional rehabilitation, with an albumin and nPCR increase (except for the categorized group of < 5 g protein/day). Although the increment of potassium was statistically significant, it was not clinically relevant in increasing the risk of hyperkalaemia. Further analyses are needed to understand the best targets for the energy and protein contribution of ONS.