The effect of oral supplementation with a combination of beta-hydroxy-beta-methylbutyrate, arginine and glutamine on wound healing: a retrospective analysis of diabetic haemodialysis patients

BMC Nephrology

Ali Tamer¹  Mustafa Cahit Demirci²  Mehmet Cilci²  Mehmet Gunduz³  Ozkan Gungor⁴  Savas Sipahi⁵ 

[1] Clinic of Internal Diseases, Sakarya University Training and Research Hospital, Sakarya, Turkey;Private Nefromed Hemodialysis Center, Sakarya, Turkey;Clinic of Internal Diseases, Yozgat State Hospital, Yozgat, Turkey;Department of Nephrology, Ege University Faculty of Medicine, Izmir, Turkey;Clinic of Nephrology, Sakarya University Training and Research Hospital, Adnan Menderes Cad. Saglik Sok. No: 193, Adapazari, Sakarya, Turkey

关键词: Hydroxy methylbutyrate;    Glutamine;    Arginine;    Oral nutrition support;    Haemodialysis;    Diabetic foot;   

Others  :  1083030
DOI  :  10.1186/1471-2369-14-8

 received in 2012-07-26, accepted in 2013-01-07,  发布年份 2013

【 摘 要 】

Background

Diabetes is an important reason for end-stage renal failure and diabetic foot wounds worsen the life qualities of these patients. Protein and amino acid support accelerates the wound healing. The purpose of this retrospective study is to examine the effect of beta-hydroxy-beta-methylbutyrate, arginine and glutamine (Abound®) supplementation on the wound healing.

Methods

A total of 11 diabetic dialysis patients were included in this retrospective study aiming to evaluate the effect of the diet support with beta-hydroxy-beta-methylbutyrate, arginine and glutamine on wound healing in diabetic dialysis patients. Pre-treatment and post-treatment wound depth and wound appearance were scored in accordance with the “Bates-Jensen” wound assessment tool. The results of 4-week treatment with beta-hydroxy-beta-methylbutyrate, arginine and glutamine (Abound®) support were evaluated in terms of wound healing.

Results

The mean age of patients was 66 (SD: 10, range: 51-81) and 9 (81.8%) of them were males. After the 4-week treatment, in accordance with the Bates-Jensen scoring, healing was observed on the wound depth score of 7(63.6%) patients and on wound appearance score of 8(72.7%) patients out of 11. While the wound depth score of 4(36.4%) cases and wound appearance score of 3(27.3%) cases remained the same, no deterioration was observed on any cases throughout the follow-up period.

Conclusion

In conclusion, our findings revealed that Abound treatment makes a positive contribution to the wound healing in diabetic dialysis patients.

【 授权许可】

   
2013 Sipahi et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Gupta A, Gupta P, Biyani M: Targeted therapies in diabetic nephropathy: an update. J Nephrol 2011, 24:686-695.
• [2]Lipsky BA, Peters EJ, Senneville E, Berendt AR, Embil JM, Lavery LA, Urbančič-Rovan V, Jeffcoate WJ: Expert opinion on the management of infections in the diabetic foot. Diabetes Metab Res Rev 2012, 28:163-178.
• [3]Lewis S, Raj D, Guzman NJ: Renal failure: implications of chronic kidney disease in the management of the diabetic foot. Semin Vasc Surg 2012, 25:82-88.
• [4]Demling RH: Nutrition, anabolism, and the wound healing process: an overview. Eplasty 2009, 9:65-94.
• [5]Wu G, Bazer FW, Davis TA, Kim SW, Li P, Marc Rhoads J, Carey Satterfield M, Smith SB, Spencer TE, Yin Y: Arginine metabolism and nutrition in growth, health and disease. Amino Acids 2009, 37:153-168.
• [6]Miller AL: Therapeutic considerations of L-glutamine: a review of the literature. Altern Med Rev 1999, 4:239-248.
• [7]Alon T, Bagchi D, Preuss HG: Supplementing with beta-hydroxy-beta-methylbutyrate (HMB) to build and maintain muscle mass: a review. Res Commun Mol Pathol Pharmacol 2002, 111:139-151.
• [8]HMB (ß-hydroxy-ß-methylbutyrate): A scientific review. New Perspective on Lean Body Mass. http://abbottnutrition.com/Downloads/hmb_a_scientific_review.pdf webcite
• [9]Williams JZ, Abumrad N, Barbul A: Effect of a specialized amino acid mixture on human collagen deposition. Ann Surg 2002, 236:369-374.
• [10]Bates-Jensen B: New pressure ulcer status tool. Decubitus 1990, 3:14-15.
• [11]Singh N, Armstrong DG, Lipsky BA: Preventing foot ulcers in patients with diabetes. JAMA 2005, 293:217-228.
• [12]Gunter W, Muller N, Busch M, Eidner G, Kloos C, Hunger-Battefeld W, Müller UA: Diabetic foot syndrome and renal function in type 1 and 2 diabetes mellitus show close association. Nephrol Dial Transplant 2009, 24:1896-1901.
• [13]Sherman AR, Barkley M: Nutrition and wound healing. J Wound Care 2011, 20:357-358. 360, 362-367
• [14]Slater GJ, Jenkins D: Beta-hydroxy-beta-methylbutyrate (HMB) supplementation and the promotion of muscle growth and strength. Sports Med 2000, 30:105-116.
• [15]Arana V, Paz Y, González A, Méndez V, Méndez JD: Healing of diabetic foot ulcers in L-arginine-treated patients. Biomed Pharmacother 2004, 58:588-597.
• [16]da Costa MA, Campos AC, Coelho JC, de Barros AM, Matsumoto HM: Oral glutamine and the healing of colonic anastomoses in rats. JPEN J Parenter Enteral Nutr 2003, 27:182-185.
• [17]Clark RH, Feleke G, Din M, Yasmin T, Singh G, Khan FA, Rathmacher JA: Nutritional treatment for acquired immunodeficiency virus-associated wasting using beta-hydroxy beta-methylbutyrate, glutamine, and arginine: a randomized, double-blind, placebo-controlled study. JPEN J Parenter Enteral Nutr 2000, 24:133-139.
• [18]Berk L, James J, Schwartz A, Hug E, Mahadevan A, Samuels M, Kachnic LRTOG: A randomized, double-blind, placebo-controlled trial of a beta-hydroxyl beta-methyl butyrate, glutamine, and arginine mixture for the treatment of cancer cachexia (RTOG 0122). Support Care Cancer 2008, 16:1179-1188.
• [19]Williams JZ, Barbul A: Nutrition and wound healing. Crit Care Nurs Clin North Am 2012, 24:179-200.
• [20]Tatti P, Barber A: Nutritional Supplement is Associated with a Reduction in Healing Time and Improvement of Fat Free Body Mass in Patients with Diabetic Foot Ulcers. EWMA Journal 2010, 10:13-18.