Multifaceted Nutritional Intervention In Hemodialysis Patients

MULTIFACETED NUTRITIONAL INTERVENTION IN HEMODIALYSIS PATIENTSbyZULFITRI ‘AZUAN MAT DAUDMay 2014Advisor : Dr. Pramod KhoslaMajor : Nutrition and Food ScienceDegree : Doctor of PhilosophyMortality rate in patients undergoing chronic hemodialysis (HD) in the United Statesremain unacceptably high despite improvement in dialysis technology. Cardiovascular disease(CVD) account for more than 50% of the premature death in this population. Evidences indicatethat the accelerated CVD are attributed to by malnutrition, inflammation, dyslipidemia andoxidative stress. Dietary intervention using nutrients with antioxidant, anti-inflammatory, andpotential lipid altering properties to correct the aforementioned problems remain inconclusive.Furthermore, such nutritional intervention trial is often hampered by poor compliance related tomedical and socioeconomic barriers. Therefore, a series of randomized, double-blind, placebo-controlled, parallel trials were undertaken to document the technical feasibility of ‘directlyobserved treatment’ and the global impact of several nutrients namely omega-3 and vitamin Etocotrienols on nutritional and oxidative indicators, inflammatory markers and lipid profiles in acohort of chronic HD patients. The objective of the first study was to evaluate the impact of omega-3 plus liquid proteinsupplement on serum albumin, plasma lipids and other indicator of nutrition and inflammation.