Oral Nutrition Supplementation in the Health Dynamics of Dialysis Patients

Inadequate nutritional management poses health challenges to patients on dialysis. Its iatrogenic effects include intradialytic hypotension, gastrointestinal intolerance, muscle cramps, inflammations, renal osteodystrophy, poor quality of life, and protein energy wasting (PEW). Nutrition care helps manage these effects. Nutritional intervention for these patients includes dietary counseling with food modifications. Oral nutritional supplements (ONS) are recommended when kitchen-based food does not meet nutritional needs. ONS improve the nutrition status, blood parameters (serum albumin, pre-albumin), sleep quality index, hand grip strength, body mass index, nutritional intake, muscle mass, and physical and mental quality of patients on dialysis. ONS types that have shown improvement are soya protein, whey protein, collagen peptide, egg albumin, branched-chain amino acid, a blend of casein, and whey. Enhancing protein digestion by using proteolytic enzymes with a high-protein diet would also help in PEW treatment. Ghrelins also improve the appetite and food intake. The nutrition supplements recommended to dialysis patients need to be used appropriately to suit patient-specific requirements and challenges. A multidisciplinary team and holistic approach are important for better patient outcomes.