Effect of Protein Supplementation on Health-Related Quality of Life in Individuals With Advanced Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition Pub Date : 2026-03-01 Epub Date: 2025-08-26 DOI:10.1053/j.jrn.2025.08.003

Yasmin Iman BSc , Krista Rossum MD , Amanda Krueger RD , Favian Co BSc , Makan Pourmasoumi PhD Candidate , Ruth Ewhrudjakpor BSc (Hons) , Nicole Askin MLIS , Rebecca C. Mollard PhD , Clara Bohm MD

{"title":"Effect of Protein Supplementation on Health-Related Quality of Life in Individuals With Advanced Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","authors":"Yasmin Iman BSc , Krista Rossum MD , Amanda Krueger RD , Favian Co BSc , Makan Pourmasoumi PhD Candidate , Ruth Ewhrudjakpor BSc (Hons) , Nicole Askin MLIS , Rebecca C. Mollard PhD , Clara Bohm MD","doi":"10.1053/j.jrn.2025.08.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>We performed a systematic review and meta-analysis to evaluate the effect of protein/amino acid supplementation on health-related quality of life (HRQOL) in advanced chronic kidney disease (CKD) including individuals on dialysis.</div></div><div>We performed a systematic review and meta-analysis to evaluate the effect of protein/amino acid supplementation on health-related quality of life (HRQOL) in advanced chronic kidney disease (CKD) including individuals on dialysis.</div><div><h3>Methods</h3><div>Medline, Cochrane Central, Embase, and Cumulative Index to Nursing and Allied Health Literature were searched (establishment until August 2022) for randomized controlled trials evaluating the effect of protein or amino acid supplementation (>5 g/day) on individuals with advanced chronic kidney disease (estimated glomerular filtration rate <30 mL/min and/or on dialysis). Primary outcome was change in HRQOL. Secondary outcomes included biochemical, anthropometric measures, and physical function. Two reviewers independently screened articles for inclusion based on the prespecified criteria, extracted data, and assessed risk of bias. Meta-analysis was performed by pooling mean difference or standardized mean difference using a random effects model if at least three included studies reported our prespecified outcomes.</div></div><div>Medline, Cochrane Central, Embase, and Cumulative Index to Nursing and Allied Health Literature were searched (establishment until August 2022) for randomized controlled trials evaluating the effect of protein or amino acid supplementation (>5 g/day) on individuals with advanced chronic kidney disease (estimated glomerular filtration rate <30 mL/min and/or on dialysis). Primary outcome was change in HRQOL. Secondary outcomes included biochemical, anthropometric measures, and physical function. Two reviewers independently screened articles for inclusion based on the prespecified criteria, extracted data, and assessed risk of bias. Meta-analysis was performed by pooling mean difference or standardized mean difference using a random effects model if at least three included studies reported our prespecified outcomes.</div><div><h3>Results</h3><div>Of 5,699 articles, 17 were included for analysis. We found no improvement in HRQOL in qualitative synthesis of four studies. Protein and/or amino acid supplementation was associated with an improvement in serum albumin (mean difference (MD) = 1.76 g/L, 95% confidence interval (CI) [0.67, 2.84], <em>P</em> = .002, I<sup>2</sup> = 88%) and body mass index (BMI) (mean difference = 0.29 kg/m<sup>2</sup>, 95% confidence interval [0.10, 0.49], <em>P</em> = .004, I<sup>2</sup> = 0%), as compared with controls.</div></div><div>Of 5,699 articles, 17 were included for analysis. We found no improvement in HRQOL in qualitative synthesis of four studies. Protein and/or amino acid supplementation was associated with an improvement in serum albumin (mean difference (MD) = 1.76 g/L, 95% confidence interval (CI) [0.67, 2.84], <em>P</em> = .002, I<sup>2</sup> = 88%) and body mass index (BMI) (mean difference = 0.29 kg/m<sup>2</sup>, 95% confidence interval [0.10, 0.49], <em>P</em> = .004, I<sup>2</sup> = 0%), as compared with controls.</div><div><h3>Conclusions</h3><div>A small number of studies prevented meta-analysis for HRQOL. Statistically significant improvements in serum albumin and body mass index were observed with protein supplementation compared to controls. Small number of studies, high risk of bias, and heterogeneity of included studies support the need for rigorous clinical trials, investigating the effect of protein supplementation on patient-relevant outcomes.</div></div><div>A small number of studies prevented meta-analysis for HRQOL. Statistically significant improvements in serum albumin and body mass index were observed with protein supplementation compared to controls. Small number of studies, high risk of bias, and heterogeneity of included studies support the need for rigorous clinical trials, investigating the effect of protein supplementation on patient-relevant outcomes.</div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 2","pages":"Pages 222-235"},"PeriodicalIF":3.2000,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Renal Nutrition","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1051227625001852","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/26 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

We performed a systematic review and meta-analysis to evaluate the effect of protein/amino acid supplementation on health-related quality of life (HRQOL) in advanced chronic kidney disease (CKD) including individuals on dialysis.

Methods

Medline, Cochrane Central, Embase, and Cumulative Index to Nursing and Allied Health Literature were searched (establishment until August 2022) for randomized controlled trials evaluating the effect of protein or amino acid supplementation (>5 g/day) on individuals with advanced chronic kidney disease (estimated glomerular filtration rate <30 mL/min and/or on dialysis). Primary outcome was change in HRQOL. Secondary outcomes included biochemical, anthropometric measures, and physical function. Two reviewers independently screened articles for inclusion based on the prespecified criteria, extracted data, and assessed risk of bias. Meta-analysis was performed by pooling mean difference or standardized mean difference using a random effects model if at least three included studies reported our prespecified outcomes.

Results

Of 5,699 articles, 17 were included for analysis. We found no improvement in HRQOL in qualitative synthesis of four studies. Protein and/or amino acid supplementation was associated with an improvement in serum albumin (mean difference (MD) = 1.76 g/L, 95% confidence interval (CI) [0.67, 2.84], P = .002, I² = 88%) and body mass index (BMI) (mean difference = 0.29 kg/m², 95% confidence interval [0.10, 0.49], P = .004, I² = 0%), as compared with controls.

Conclusions

A small number of studies prevented meta-analysis for HRQOL. Statistically significant improvements in serum albumin and body mass index were observed with protein supplementation compared to controls. Small number of studies, high risk of bias, and heterogeneity of included studies support the need for rigorous clinical trials, investigating the effect of protein supplementation on patient-relevant outcomes.

查看原文本刊更多论文

补充蛋白质对晚期慢性肾病患者健康相关生活质量的影响：随机对照试验的系统回顾和荟萃分析

目的：我们进行了一项系统回顾和荟萃分析，以评估蛋白质/氨基酸补充对包括透析个体在内的晚期慢性肾病（CKD）患者健康相关生活质量（HRQOL）的影响。方法：检索Medline、Cochrane Central、Embase和CINAHL（建立至2022年8月）的随机对照试验，评估蛋白质或氨基酸补充（bbb50 g/天）对晚期CKD患者（eGFR < 30 ml/min和/或透析患者）的影响。主要观察指标为HRQOL的变化。次要结局包括生化、人体测量和身体功能。两名审稿人根据预先指定的标准、提取的数据和评估的偏倚风险独立筛选纳入的文章。如果至少有3项纳入的研究报告了我们预先指定的结果，则采用池化平均差或使用随机效应模型的标准化平均差进行meta分析。结果：5699篇文献中，17篇纳入分析。在4项定性综合研究中，我们发现HRQOL没有改善。与对照组相比，补充蛋白质和/或氨基酸与血清白蛋白（MD = 1.76 g/L, 95%CI [0.67, 2.84]， P=0.002, I2= 88%）和体重指数（MD = 0.29 kg/m2, 95%CI [0.10, 0.49]， P=0.004, I2=0%）的改善相关。结论：少数研究阻止了HRQOL的meta分析。与对照组相比，补充蛋白质可显著改善血清白蛋白和BMI。研究数量少，偏倚风险高，纳入的研究存在异质性，因此需要进行严格的临床试验，调查补充蛋白质对患者相关结果的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Renal Nutrition 医学-泌尿学与肾脏学

CiteScore

5.70

自引率

12.50%

发文量

146

审稿时长

6.7 weeks

期刊介绍： The Journal of Renal Nutrition is devoted exclusively to renal nutrition science and renal dietetics. Its content is appropriate for nutritionists, physicians and researchers working in nephrology. Each issue contains a state-of-the-art review, original research, articles on the clinical management and education of patients, a current literature review, and nutritional analysis of food products that have clinical relevance.