The Effects of Oral Energy-Dense Supplements on Nutritional Status in Nondiabetic Maintenance Hemodialysis Patients: A Randomized Controlled Trial.

BACKGROUND AND OBJECTIVES: Fat-based energy-dense nutritional supplements may offer benefits over protein- or carbohydrate-dense supplements for patients receiving dialysis because of the adverse metabolic consequences of the latter. We conducted a randomized controlled trial to assess the effects of the short-term use of a fat-based nutritional supplement on various measures of nutritional status in patients receiving maintenance hemodialysis who have low dietary energy intake. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We enrolled nondiabetic patients receiving hemodialysis for >3 months who had inadequate dietary energy intake (<30 kcal/kg per day). The participants were randomly assigned in a 1:1 ratio to receive an oral fat-based energy-dense supplement (300 kcal daily) or routine care for 12 weeks (n=120 per group). The primary outcome was the change in phase angle measured by bioelectrical impedance analysis, a marker of cell integrity and body cell mass, from the baseline to week 12. The secondary outcomes were changes in quality of life. Other outcomes included laboratory nutritional indicators and physical examinations. RESULTS: The average age of the total population was 47 (SD: 12) years, and 55% were men. The median of dialysis vintage was 43.4 (22.5-76.3) months; 240 participants were randomly assigned to the intervention (n=120) or control group (n=120). In total, 228 (95%) participants completed the trial. The change in phase angle did not differ significantly between the intervention and control groups (estimate, 0.0; 95% confidence interval, -0.1 to 0.1 versus estimate, 0.0; 95% confidence interval, -0.1 to 0.1; estimated difference, 0.0; 95% confidence interval -0.2 to 0.2; P=0.99). None of the 19 domains of quality of life differed between the groups. Adverse events were reported in 23 (19%) participants in the control group and 40 (33%) participants in the intervention group. CONCLUSIONS: In nondiabetic patients on maintenance hemodialysis, short-term administration of fat-based energy-dense nutritional supplement has no clinically significant effect on nutritional status as measured by phase angle. PODCAST: This article contains a podcast at https://https://www.asn-online.org/media/podcast/CJASN/2021_08_03_CJN16821020.mp3.

High dose of epigallocatechin-3-gallate inhibits proliferation and induces apoptosis of H9C2 cardiomyocytes through down-regulation of SIRT1.

BACKGROUND: Previous studies have suggested that high doses of (-)-epigallocatechin-3-gallate (EGCG) can induce toxicity in the liver, kidneys, and intestine. However, there have been no reports of myocardiotoxicity following treatment with EGCG. In this study, we investiged the proliferation and apoptosis of H9C2 cardiomyocytes treated with high dose of EGCG. METHODS: Cell proliferation was measured by CCK8 assay, cell apoptosis rate was evaluated by TUNEL assay, and the expression alterations of Sirtuin 1 (SIRT1) protein was detected by Western blotting. RESULTS: EGCG inhibits proliferation and induces apoptosis in time- and dose-dependent manner in H9C2 cardiomyocytes. SIRT1 participates in the inhibitory effect of EGCG on cell proliferation and apoptosis induction in H9C2 cardiomyocytes. CONCLUSION: This study demonstrates that high doses of EGCG inhibit proliferation and induce apoptosis in H9C2 cardiomyocytes. Down-regulation of SIRT 1 protein expression may be involved.