Discussion
protein-energy wasting, CKD, malnutrition
MALNUTRITION
This study is the first to explore oral nutritional supplement effects in an older individual in stage 3–5 CKD at the 3-month follow-up period. We discovered that maintaining nutritional status consists of the MNA-SF, physical activity and body composition in both groups. A recent systematic review indicated that dialysis treatment involving a mix of various macronutrients for up to 12 months significantly increased lean body mass [In a previous study, an LPD of approximately 85% for patients with CKD stages 3–5 offered an insufficient daily calorie intake despite receiving standard routine diet counseling, while also associated with a slight decrease in gait speed [This study's results indicated that an LPD plus a 6% LPF provided no changes in energy and protein intake while increasing fatty acid and specific micronutrient intake during the 3-month follow-up period. Outcomes could be attributed to the two groups following the target calorie and protein intake under a dietitian’s guidance. The intervention group used oral nutritional supplements (6% LPF) to replace high-protein foods and achieve target energy intake and protein control. The control group used natural food during implementation. In a previous survey study, protein intake restrictions required energy supplements to avoid malnutrition and protein-energy wasting, potentially facilitating the use of protein-free products or other options as their primary energy source [Recent reports found that n-3 PUFA supplementation through a fish oil source enhanced muscle protein synthesis rates in older adults, improving muscle strength and boosting physical performance [Regarding clinical parameters, this study also concluded that BUN was significantly reduced in the intervention group over three months. Previous randomized controlled trials have suggested that low-protein formula supplements could improve LPD adherence and kidney function outcomes [This study has several limitations. First, this study was conducted in a single center; therefore, the generalizability of the results may be poor. Second, concerning dietary intake, although previous studies of homebound older adults have proven reliable using a 24-h dietary record for energy intake, there may be a validity bias when describing information [