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Innovative Functional Food Based on Apulian Lens Culinaris for Contrasting Sarcopenia in Dialysis Patients

Not Applicable
Completed
Conditions
Sarcopenia
Hemodialysis
Interventions
Dietary Supplement: NATURLENS
Registration Number
NCT04223206
Lead Sponsor
Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari
Brief Summary

The objective of the pilot study is to validate the clinical use of a dietary supplement for contrasting sarcopenia in dialysis patients.

The study aims at evaluating the effects of a nutritional supplement, consisting of flour from Lens culinaris of Altamura IGP, pea proteins and vitamins (A, B12, D, E) by achieving the following objectives:

* Reduction of sarcopenia conditions, through improvement of nutritional and anthropometrical levels

* Decrease of the serum levels of microbiota-derived uremic toxins

* Reduction of intestinal permeability and inflammatory markers

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
20
Inclusion Criteria
  • patients > 60 years old
  • omnivore controlled normocaloric diet (30 Kcal/kg ideal weight)
  • patients with chronic kidney disease (CKD) and routine hemodialysis or peritoneal dialysis
  • patients with primary sarcopenia identified with score ≥ 4 at SARC-F Questionnaire
  • informed consent signed
Exclusion Criteria
  • participation to another clinical trial
  • limb removal by amputation
  • altered blood sugar level (HbA1c>8.0%) or type I diabetes mellitus
  • neoplastic events in the last 5 years
  • gut, systemic or autoimmune chronic inflammatory pathologies
  • use of antibiotics or probiotics up to 30 days prior to recruitment
  • life expectancy of less than one year
  • treatment with corticosteroids or immunosuppressive drugs (excluded prednisone at dose <5 mg at day)
  • positivity to hepatitis B and C virus, HIV1/2 and syphilis
  • oxygen saturation in the blood at rest <93%
  • alcohol or drug abuse in the last 3 years
  • clinically important alterations of the following laboratory parameters: hemoglobin <9.0 g / dL, white blood cells <2.500 / μl, platelet count <100.000 / μl, AST and ALT> 3 times the upper limit of the norm, coagulopathy (INR> 1.3 ) not due to a reversible cause (eg Warfarin and / or factor Xa inhibitors)
  • uncontrolled hypertension (resting systolic blood pressure> 180 mmHg or diastolic blood pressure> 110 mmHg)
  • unstable angina pectoris, severe peripheral artery disease, coronary bypass surgery, angioplasty or acute major cardiocirculatory diseases in the previous 3 months
  • definite congestive heart failure class III or IV (NYHS) or ejection fraction <25%
  • severe pulmonary dysfunction: acute exacerbation of chronic obstructive pulmonary disease in phase III or IV (Gold classification) and / or PaO2 levels <60 mmHg
  • significant intestinal malabsorption due to partial ileal bypass or other causes
  • score ≤ 24 at the Mini Mental State Examination (MMSE) or presence of cognitive or linguistic limits that prohibit informed consent or possible elements of study
  • diagnosis of disabling neurological disorder, including Parkinson's disease, amyotrophic lateral sclerosis, multiple sclerosis, cerebrovascular accident with residual deficits (for example, muscle weakness or gait disorder), dementia or any psychiatric condition that reduces protocol compliance
  • have a history or evidence of any condition, therapy, laboratory abnormality or other circumstances that could confuse the results of the study or interfere with the patient's participation throughout the duration of the study

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Hemodialysis with sarcopeniaNATURLENS10 HD patients, affected by sarcopenia will a undergo 3-months supplementation with NATURLENS
Primary Outcome Measures
NameTimeMethod
Evaluation of muscle mass3 months

Change of muscle mass by bioelectrical impedance assessment (BIA)

Secondary Outcome Measures
NameTimeMethod
Change of serum concentration of D-lactate3 months

Change of D-lactate serum concentration (uM)

Change of Mini Nutritional Assessment (MNA) score3 months

Measurement of MNA questionnaire (12-14 points, normal nutritional status; 8-11 points, at risk of malnutrition; 0-7, malnourished)

Change of anthropometric parameter3 months

Measurement of the arm circumference (cm)

Change of body mass index (BMI)3 months

Measurement of BMI (kg/m\^2)

Change of gastrointestinal symptoms3 months

Change of gastrointestinal symptoms assessed by Gastrointestinal Symptom Rating Scale (GSRS) questionnaire (15 items scored 1-7 each, 1 representing the best and 7 the worse outcome for each item).

Change of serum concentration of inflammatory markers3 months

Change of serum concentrations of interleukins: IL-6, TNF-α, IL-1, IL-8, IL-10 (pg/mL) evaluated by ELISA

Change of sarcopenia conditions3 months

Change of sarcopenia assessed by the European Working Group on Sarcopenia in Older People (EWGSOP) guidelines through the SARC-F (Strength, Assistance with walking, Rise from a chair, Climb stairs and Falls) questionnaire. The SARC-F scale scores range from 0 to 10 (i.e. 0-2 points for each item; 0=best to 10=worst) and represents no sarcopenia (0-3) and sarcopenia (4-10).

Change of stool type3 months

Change of stool type evaluated by BRISTOL Stool Scale (range 1-7, lower and higher values representing worse outcome, middle values representing better outcome).

Change of serum concentration of IS and pCS3 months

Change of free and total indoxyl sulfate (IS) and p-cresyl sulfate (pCS) serum concentrations (μg/mL) assessed by liquid chromatography/mass spectrometry

Change of blood glucose level3 months

Change of glycemia concentration (mg/dl)

Change of insulin levels3 months

Change of insulin concentration (pmol/L)

Change of endocrine parameters3 months

Change of C-peptide, growth hormone (GH), insulin-like growth factor 1 (IGF-1), testosterone concentration (ng/mL)

Trial Locations

Locations (1)

AOUConsorziale Policlinico Di Bari

🇮🇹

Bari, Italy

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