EFFECTS OF OMEGA-3 AND PROTEIN SUPPLEMENTATION ON NUTRITIONAL AND INFLAMMATORY INDICES IN HEMODIALYSIS PATIENTS – A PILOT STUDY.

Intervention to correct malnutrition and chronic inflammation in dialysis patients is often impeded by poor compliance due to medical and socioeconomic barriers. Therefore we performed a pilot study to investigate the technical feasibility of “directly observed treatment” of nutritional supplementation (protein and omega-3 fatty acids) and its effects on nutritional and inflammatory markers in low socio-economic status hemodialysis population. Sixty-three eligible patients agreed to participate. Two intervention groups received 30 mL of a liquid protein supplement plus either 2.4 gm omega-3 (1.8 gm eicosapentaenoic acid + 0.6 gm docosahexaenoic acid) or a placebo, three times per week after their routine dialysis session for 6 months. Serum albumin, plasma lipids, and other indicators of nutritional and inflammatory status were measured. Statistical differences after treatment and between groups were determined using paired t-test and independent t-test, respectively. Directly observed nutritional supplementation resulted in a significant improvement in the LDLC/HDLC ratio in the omega-3 group as compared to the placebo group (P = 0.043). For the omega-3 group, serum albumin was also marginally higher after 6 months as compared to baseline (P = 0.07). Other nutritional and inflammatory markers were unaffected by intervention. In conclusion, “Directly observed treatment” is technically feasible with an omega-3 based supplement (as opposed to a pure protein supplement) showed beneficial effects on the lipid profile