A novel egg white-based solid oral nutritional supplement improves serum albumin and protein intake in patients on peritoneal dialysis: A prospective interventional study

Abstract

Background & aims

Protein-energy wasting (PEW) is a major predictor of adverse outcomes in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Achieving the recommended dietary protein intake remains a significant clinical challenge. This study aimed to evaluate the safety and efficacy of “Egg Bite,” a novel, palatable, solid oral nutritional supplement (ONS) derived from egg white, in improving the nutritional status of CAPD patients.

Methods

In this prospective, single-arm interventional trial, 35 CAPD patients with serum albumin ≤ 4.0 g/dL consumed a daily supplement of “Egg Bite” (105 g/day, providing 25.7 g protein and 392 kcal) for 21 consecutive days. The primary outcome was the change in serum albumin. Secondary outcomes included changes in overall dietary intake, anthropometric measures, and key biochemical markers (renal, metabolic, and inflammatory). Assessments were performed at baseline, day 14, and day 21.

Results

Thirty-five of 42 enrolled patients (83%) completed the study. Daily supplementation resulted in a significant increase in mean serum albumin from 3.38 ± 0.42 g/dL at baseline to 3.48 ± 0.43 g/dL at day 21 (P = 0.001). Total protein intake rose significantly from 0.9 ± 0.2 g/kg/day to 1.4 ± 0.4 g/kg/day (P < 0.001), successfully meeting guideline recommendations. Energy intake also increased significantly (P < 0.001). No significant changes were observed in body weight or BMI. The supplement was well-tolerated, with non-significant increases in serum potassium and stable hemoglobin levels. Minor but statistically significant increases in BUN and creatinine were noted, consistent with increased protein metabolism. In patients with baseline hypoalbuminemia (n=19), hs-CRP showed a non-significant downward trend from 10.44 to 8.10 mg/dL.

Conclusions

Daily supplementation with “Egg Bite,” a novel egg white-based solid ONS, is a safe, well-tolerated, and effective intervention for improving protein-energy status in CAPD patients. It significantly elevates serum albumin and dietary protein intake to meet clinical targets without inducing adverse metabolic effects. “Egg Bite” represents a promising tool for managing PEW, though longer-term studies are needed to evaluate its impact on body composition and clinical outcomes.