Sarcopenia: A Major Challenge in Elderly Patients with End-Stage Renal Disease

Table 1

Review of the most important randomized controlled trials concerning nutrition treatment in ESRD patients.

Author	Implemented treatment	𝑁	Results
Sundell et al. [96]	Pro-Stat 64 administered during hemodialysis	6	(i) Increased essential, nonessential, and total plasma amino acids concentration.; (ii) Whole-body protein breakdown and net protein balance became statistically significantly better during HD in a dose-dependent manner.
Allman et al. [97]	Polycose-glucose polymer	9	(i) A mean increase in body fat of 1.8 kg and the lean body mass increased by 1.3 kg.; (ii) The weight gain maintained after 6 months.
Milano et al. [98]	Glucose polymer	27	(i) Increase in body weight, body mass index, triceps skinfold, and brachial circumference at the end of the third month.; (ii) Results were confirmed at 6 months in 18 patients that completed the study (mean body weight gain—2.4 kg).; (iii) The nutritional status improved in only 4 patients at the end of the study.
Kuhlmann et al. [99]	Dietary treatment—3 groups: A: 45 kcal/kg/d and 1.5 g protein/kg/d; B: 35 kcal/kg/d and 1.2 g protein/kg/d; C: spontaneous intake supplemented with 10% of mean protein and energy intake	18	(i) Weight gain (1.2±0.4 kg) observed only in group A.; (ii) Serum albumin levels increased by 1.0±0.5 g/L only in group A.
Patel et al. [100]	Dietary supplements	17	(i) Dietary supplements significantly increased both the nPCR and the total protein intake at 2 months and after 8 months.; (ii) No change in the nutritional status of the subjects.
Hiroshige et al. [101]	Oral branched-chain amino acids (BCAAs) supplementation (12 g/day)	28	(i) Anorexia and poor oral protein and caloric intakes improved.; (ii) The improvement in plasma BCAA levels.; (iii) Increase and mean plasma albumin concentration.
Leon et al. [102]	Identification and intervention on nutritional barriers (depression, poor knowledge, poor appetite, help with shopping or cooking, low fluid intake, inadequate dialysis dose, depression, difficulty chewing, difficulty swallowing, gastrointestinal symptoms, and acidosis)	180	(i) Intervention patients had greater increases in albumin levels compared with control patients after 1 year.; (ii) Greater increases in energy intake and protein intake in the intervention patients.; (iii) The intervention most effective for barriers related to poor nutritional knowledge, help needed with shopping or cooking, and difficulty swallowing.
Fouque et al. [103]	Renilon 7.5(R) daily for 3 months	86	(i) Increased DPI and DEI compared to control group.; (ii) No difference in serum albumin and prealbumin changes between groups.; (iii) Improved SGA and QOL.
Caglar et al. [104]	Oral nutritional supplement specifically formulated for CHD patients	85	(i) Significant increases in concentrations of serum albumin and serum prealbumin.; (ii) SGA score increased 14% by the end of the study.