Protein and energy intake: Comparison of two food services in patients during hemodialysis treatment

Abstract

Objectives: Radboud University Medical Center introduced a new food service (NFS) to the hemodialysis (HD) department, which contains several small protein-rich foods and adheres to the Dutch dietary HD guidelines. The objectives were to investigate whether the NFS improves protein and energy intake compared with the old food service (OFS), the number of symptomatic hypotensive events (SHEs), and patient satisfaction.

Methods: This was a prospective cohort (pilot) study of 25 adult patients with HD at the Radboud University Medical Center between August 2018 and February 2019. Differences in protein and energy intake over time by repeated measurements of the OFS and NFS were evaluated by linear mixed models with adjustments for confounders. SHEs, defined as a systolic drop >20 mmHg between two blood pressure measurements and 1) temporary or permanent stop ultrafiltration, 2) nausea, or 3) dizziness were collected. Patient satisfaction was determined by means of a self-developed questionnaire.

Results: Protein and energy intake for the OFS and NFS differed significantly. Mean ± standard deviation for protein intake was 26 ± 11 g and 31 ± 13 g, respectively, and for energy intake 603 ± 218 kcal and 724 ± 244 kcal, respectively. No increase in SHEs occurred between the food services (2 SHEs at OFS vs 1 SHE at NFS). OFS patient satisfaction was graded 6.7 ± 2.3 and NFS was graded 7.3 ± 1.7.

Conclusions: NFS resulted in increased protein and energy intake and patient satisfaction, but no increase in SHEs was observed.

Keywords: Energy intake; Hemodialysis; Patient satisfaction; Protein intake; Symptomatic hypotensive event.