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NUTRITIONAL STATUS OF PATIENTS ON PROTEINEX. STUDY OF PROTEINEX ON by alextt

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									                                               NUTRITIONAL STATUS OF PATIENTS ON PROTEINEX. STUDY OF PROTEINEX ON
                                               HEMODIALYSIS POPULATION IMPACTING POSITIVE NUTRITIONAL OUTCOMES
                                               Presented by: Mary R. Pinto, PHNC,RD,LD/N
       International Division, Inc.


      OBJECTIVE                                                                                        RESULTS
  To increase the Albumin of ESRD Patients on Dialysis with levels below                          Eighteen percent (18%) of the patients had some type of wound which healed
  3.4. To increase and stabilize the BUN levels of ESRD Patients on                               by the end of the study. Patients reported that they had more energy and stated
  Dialysis of 55 or below. To maintain normal interadialytic weight gains of                      they preferusing Proteinex because of fluid restrictions. The patients
  2.0 or below. To increase the nutritional stability of Patients over a three                    commented that the taste was tolerable, but needed some flavor enhancement.
  month period.                                                                                   All of the patients’ Albumins improved.
                                                                                                  Dry Wt. Remained stable or increased depending on the patient. BUN
                                                                                                  increased with most patients and became stable. Eighty five percent (85%) of
      INTRODUCTION                                                                                patients reported that they felt stronger, and had more energy. Albumin
                                                                                                  increased from 3.2 - 3.80. BUN levels increased from 60.85 to 69.82.
  •   Serum albumin levels have been used extensively to assess the
      nutritional status of individuals with and without chronic renal failure
      (CRF).17 Malnutrition is common in the end-stage renal disease                                   CONCLUSION
      (ESRD) population,18 and hypoalbuminemia is highly predictive of
                                                                                                  The focus of the study was to demonstrate that Proteinex could significantly
      future mortality risk when present at the time of initiation of chronic
                                                                                                  increase the nutritional standards of ESRD Patient’s on Hemodialysis that
      dialysis as well as during the course of maintenance dialysis (MD).14,19-27
                                                                                                  were nutritionally compromised. The results concluded that Albumin and
  •   Serum albumin levels may fall modestly with a sustained decrease in                         BUN levels improved. There was no increase in fluid gains due to Proteinex.
      dietary protein and energy intake and may rise with increased protein                       Proteinex has a definite role in improving the patient’s quality of life. KDOQI
      or energy intake.28 Conversely, serum albumin levels may fall acutely                       guidelines set forth were met and passed. Economical solution of dealing with
      with inflammation or acute or chronic stress and increase following                         nutritionally compromised patients. As Dietitians in a clinic setting, it should
      resolution or recovery.                                                                     be our mission and goal to keep striving to improve the nutritional out comes
                                                                                                  of our patients. This is just one way we can make a marked improvement in
  •   Llorens Pharmaceutical supplied Mary R. Pinto with the necessary
                                                                                                  our Patient’s quality of life.
      number of samples in order to conduct the study for a period of 3 months.
  •   This study will show the efficacy and the positive changes that a high
      concentrated protein supplement as Proteinex® can produce in he                                                  TABLES: Patients on Proteinex® before & after
      modialysis patients in 3 months.
                                                                                                                         Patient                        Before          After
                                                                                                                           1                             3.4             3.6
      CRITERIA
                                                                                                                                2                                 3.7    3.8
  +ESRD Patients on Hemodialysis.
                                                                                                                                3                                 3.6    3.7
  +Patients with an Albumin 3.5 or below. Patients with a BUN of 55 or
  below. Co-morbidity of Hepatitis will be ruled out.                                                                           4                                 3.5    3.9
                                                                                                                                5                                 2.9    3.4
      DESCRIPTION OF THE STUDY                                                                                                  6                                 3.4    3.6

  +Study was conducted for a 3 month period from July - September 2002.                                                         7                                 3.7    3.9
  Patients consisted of 16 subjects that were screened to meet criteria.                                                        8                                 3.2    3.5
  +Monitoring was conducted weekly for compliance and acceptability of
                                                                                                                                9                                 3.6     4
  Proteinex. Monthly Lab work was evaluated for Albumin and BUN levels.
                                                                                                                                10                                3.2    3.5
  PRIMARY OUTCOME MEASURE:                                                                                                      11                                3.2    3.6
  +All patients who were on Proteinex® for 3 months had a positive change
  in albumin level.                                                                                                             12                                3.6     4
                                                                                                                                13                                3.7    3.7
  ANALYSIS:
  +On the tables the reader can see the studies made to the patients who                                                        14                                3.6    3.6
  were evaluated and approved to be placed on Proteinex for 3 months.                                                           15                                3.1    3.9
  +On each table, the reader can observe have the final result, prior to                                                        16                                 3     3.9
  Proteinex discontinuation.


                                                                   TABLES: BUN (Left) & Albumin (Right)
                                                                                                                         Albumin
                                                      BUN
                                      100.00                                                                  3.75


                                                                                                              3.70


                                      90.00                                                                   3.65

                                                                                                                                                        Series1
                                                                                                              3.60


                                       80.00                                                                  3.55


                                                                                                              3.50

                                       70.00                                   BUN
                                                                                                               3.45


                                                                                                               3.40

                                       60.00
                                                                                                               3.35


                                                                                                               3.30
                                       50.00
                                                                                                                3.25


                                                                                                                3.20
                                       40.00
                                                                                                                         JUNE
                                               JUNE                                                                                 JULY
                                                      JULY                                                                                 AUG
                                                             AUG                                                                                 SEPT
                                                                     SEPT




Reference: National Kidney Foundation (2000) NKF K/DOQl
Guidelines 2000, Retrieved: http://www.kidney.org/professional/kdoqi/guidelines_updates/nut_a03.html

								
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