Objectives: Inadequate dietary protein intake in adults undergoing hemodialysis is common and contributes to inflammation and mortality. Multiple factors contribute to the inability to consume protein, such as decreased appetite and gastrointestinal issues. Protein supplements are recommended, yet their effect on reducing inflammation remains unknown. The study aimed to determine the impact of whey protein isolate (WPI) and soy protein isolate (SPI) oral nutrition supplement (ONS) on high-sensitivity C-reactive protein (hs-CRP) and normalized protein catabolic rate (nPCR) in adults undergoing hemodialysis.
Methods: A 12-week double-blind crossover randomized clinical trial was conducted. For 4-week, participants consumed 135 ml (20 g total protein) of either WPI or SPI immediately after dialysis treatment. After a 4-week washout period, participants received the oppositive protein isolate for the remaining 4-week. Participants provided a monthly blood sample for analysis of hs-CRP. nPCR was calculated via the single-pool kinetic urea equation. ANOVAs and ANCOVAs were employed using Python and R with a significance of p < 0.05. Exploratory outcomes of serum albumin and uremic toxins were evaluated as well.
Results: A total of 15 participants, 73% male, 33% identified as African American with dialysis vintage of 2 years or less (60%), and 73% with the co-morbidity of hypertension, completed the entirety of the study. Participants, on average, consumed more WPI, 19.3 g, compared to SPI, 17.3 g (p=0.02). There was a statistical difference in hs-CRP concentration favoring the consumption of WPI ONS (p = 0.04) with a difference in nPCR based on the sequence in which they received the ONS (p = 0.002).
Conclusions: Providing WPI immediately after dialysis may improve inflammation due to the amount of total protein consumed. Further exploration of the long-term effects of protein-only supplementation consumption after dialysis treatment on inflammation to ultimately enhance the quality of life.
Funding Sources: International Flavors & Fragrances Inc. (IFF)
