Access Type

Open Access Thesis

Date of Award

January 2013

Degree Type

Thesis

Degree Name

M.S.

Department

Nutrition and Food Science

First Advisor

Pramod Khosla

Abstract

Kidney disease is defined by a loss of kidney function over time [1]. It is expressed in terms of glomerular filtration rate at five stages calculated by the MDRD formula [5]. The fifth stage (<15 mL/min/1.73m2) is designed as end stage renal disease requiring renal replacement therapy in the form of hemodialysis [5]. This requires the use of an artificial kidney (dialyzer) to filter out by-products from the blood for excretion [8]. The issue arises when toxin accumulation due to decreased renal function, dialytic factors such as incompatible dialyzer membranes 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), a more potent and underutilized form of Vitamin E, are being administered to attenuate this increase in inflammation via supplementation in addition to food intake. In order to attend to this issue, the nutritional status was assessed utilizing three measures: examining nutrient intake profiles (while supplementation was taken into consideration), obtaining anthropometric findings of body mass index, and analyzing biochemical profiles of serum albumin and pro-inflammatory markers (i.e. IL-6). This data was obtained via a randomized, double blind, placebo-controlled study of 81 dialysis patients. At two times over the course of 16 weeks, blood collection for serum albumin and inflammatory markers was analyzed and dietary intake was assessed using 24-hour diet recalls and Nutritionist Pro software. Statistical analyses of paired t-tests and correlation studies revealed no significant differences between the two groups later showing no noticeable effect of T3 supplementation. Reasoning may be multifactorial such as underestimation of food intake, transcription of diet recalls may not be truly representative, or T3 supplements may not have had an effect on the nutritional statuses. It may be beneficial for patients to receive more extensive nutritional counseling as opposed to nutritional supplementation to ensure compliancy with recommended intakes.

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