Oral Nutritional Supplement Helps to Improve Nutritional Status of Dialysis Dependent Patients: a Systematic Review and Meta-analysis of Randomized Controlled Trials

Overview

Journal Front Nutr

Specialty Nutritional Sciences

Date 2023 Dec 11

PMID 38075233

Authors

Song Ren

Xiaoxiu Yao

Shangqing Ren

Yunlin Feng

Affiliations

Soon will be listed here.

Abstract

Background: The prevention and treatment of malnutrition holds remarkable implications in the overall management of dialysis patients. However, there remains a dearth of comprehensive evaluations regarding the impact of oral nutrition supplement (ONS) on all pertinent dimensions of malnutrition in the dialysis population.

Methods: A systematic search was conducted in MEDLINE, EMBASE, and Cochrane Central Library. RCTs that had assessed the effects of oral nutritional supplement in dialysis-dependent populations were considered eligible. Outcomes included laboratory indicators, anthropometric measures, nutritional indices, dialysis adequacy, body composition analysis measures, and systemic inflammation indicators. The risk of bias was assessed according to Cochrane guidelines. Weighted mean difference (WMD) or standardized mean difference (SMD) with 95% confidence intervals (CIs) were pooled using a random-effects model.

Results: In all, 22 RCTs with 1,281 patients were included. The pooled analyses revealed the serum ALB, BMI, nPCR, and MIS improved by 1.44 g/L (95% CI: 0.76, 2.57), 0.35 kg/m (95% CI: 0.17, 0.52), 0.07 g/(kg d) (95% CI, 0.05, 0.10), and -2.75 (95% CI, -3.95, -1.54), respectively following ONS treatments when compared to control treatments. However, no significant differences were observed in relation to the other outcomes examined. 15 studies were rated as having high risk of bias. Visual inspection of the funnel plot and Egger test argued against the presence of publication bias.

Conclusion: ONS treatments helps to improve the nutritional status of dialysis dependent patients. More evidence is needed from future investigations with longer study duration and standardized procedures to support long-term use of ONS in this population.

Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, Identifier CRD 42023441987.

Citing Articles

The impact of predialytic oral protein-based supplements on nutritional status and quality of life in hemodialysis patients: a randomized clinical trial.

Elsayed M, Abdelkader M, ElKazaz A, Elgohary I BMC Nephrol. 2025; 26(1):103.

PMID: 40011815 PMC: 11866819. DOI: 10.1186/s12882-025-03999-3.

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