Effects of nutritional support on nutritional status and calcium and phosphorus metabolism in maintenance hemodialysis patients

Objective  To observe the effects of nutritional support on nutritional status and calcium and phosphorus metabolism in maintenance hemodialysis （MHD） patients.

Methods  From June 2023 to August 2023, patients with end-stage renal disease （ESRD） on MHD were randomized into two groups of nutritional-support and conventional-treatment （n = 35 each）. Conventional-treatment group received routine treatment while nutritional-support group had dietary and nutritional intervention on the basis of routine treatment in control group. The incidence of malnutrition, nutritional parameters, inflammatory factors, calcium and phosphorus metabolism parameters and complications were compared between two groups.

Results  After 3/6-month intervention, the incidence of malnutritionwas lower in nutritional-support group than that in conventional-treatment group （31.43% vs 57.14%, 11.43% vs 34.29%, P＜0.05）; after 3-month intervention, the levels of hemoglobin （Hb）（126.78 ± 11.22）g/L vs （115.39 ± 10.04）g/L, prealbumin （PA）（316.44 ± 25.26）g/L vs （287.54 ± 26.10）g/L and albumin （Alb）（46.08 ± 8.15）g/L vs （38.73 ± 8.11）g/L increased in both groups and nutritional-support group was higher than conventional-treatment group（P＜0.05）; after 3-month intervention, serum levels of C-reactive protein （CRP）（2.16 ± 0.45）mg/L vs （2.61 ± 0.51）mg/L, interleukin-6 （IL-6）（10.83 ± 2.61）ng/L vs （13.43 ± 2.42）ng/L and tumor necrosis factor-α （TNF-α）（89.52 ± 9.13）ng/L vs （101.64 ± 9.44）ng/L decreased in both groups and the nutritional-support group was lower than conventional-treatment group （P＜0.05）; after 3-month intervention, serum levels of calcium （S-Ca）（2.06 ± 0.20）mmol/L vs （2.25 ± 0.19）mmol/L, phosphorus （S-P）（2.20 ± 0.23）mmol/L vs （2.42 ± 0.26）mmol/L, intact parathyroid hormone （iPTH）（180.38 ± 44.82）mmol/L vs （216.54 ± 48.44）mmol/L and Ca×P （4.53 ± 0.49）mmol/L vs （5.45 ± 0.51）mmol/L decreased in both groups and nutritional-support group was lower than conventional-treatment group （P＜0.05）; overall incidence of complications was lower in nutritional-support group than that in conventional-treatment group（χ² = 4.629, P = 0.031）.

Conclusion  Nutritional support may alleviate the inflammatory response, improve their nutritional status and disrupt calcium and phosphorus metabolism in MHD patients.