Nutritional Status In A Cohort Of Hemodialysis Patients Receiving Tocotrienol Supplementation

NUTRITIONAL STATUS IN A COHORT OF HEMODIALYSIS PATIENTSRECEIVING TOCOTRIENOL SUPPLEMENTATIONbyRAJEEV SHAHANIDecember 2013Advisor: Dr. Pramod KhoslaMajor: Nutrition and Food ScienceDegree: Master of Science Kidney disease is defined by a loss of kidney function over time [1]. It is expressed interms of glomerular filtration rate at five stages calculated by the MDRD formula [5]. The fifthstage (<15 mL/min/1.73m) is designed as end stage renal disease requiring renal replacementtherapy in the form of hemodialysis [5]. This requires the use of an artificial kidney (dialyzer) tofilter out by-products from the blood for excretion [8].The issue arises when toxinaccumulation due to decreased renal function, dialytic factors such as incompatible dialyzermembranes reacting with blood, and co-morbid conditions such as infection or diabetes mellitus[3]. This increases inflammation within the body, leading to a negative nutrient/energy balance,resulting in a loss of body mass thereby increasing the mortality risk [10]. Tocotrienols (T3), amore potent and underutilized form of Vitamin E, are being administered to attenuate thisincrease in inflammation via supplementation in addition to food intake. A cohort ofhemodialysis patients was analyzed in order to study this issue. The nutritional status wasassessed utilizing three measures: examining nutrient intake profiles (while supplementation wastaken into consideration), obtaining anthropometric findings of body mass index, and analyzingbiochemical profiles of serum albumin and pro-inflammatory markers (i.e. IL-6). This data was