Changes in Nutritional Status and Bioimpedance Parameters During EAA/KA Supplementation in Elderly Patients Undergoing Maintenance Hemodialysis: A Retrospective Observational Study

Background/Objectives: Protein Energy Wasting (PEW) is common among patients undergoing maintenance hemodialysis (HD), particularly older adults, and is associated with increased frailty, susceptibility to infections, hospitalization, and mortality. Nutritional counseling alone may be insufficient to improve nutritional status in some patients. Supplementation with essential amino acids and ketoanalogues (EAA/KA) may support nutritional status in patients undergoing HD. This study aimed to evaluate changes in nutritional and bioimpedance parameters in older patients undergoing maintenance HD and receiving EAA/KA supplementation. Methods: This retrospective observational study evaluated changes over six months in 10 patients undergoing maintenance HD with a baseline Malnutrition–Inflammation Score (MIS) greater than 7 who received EAA/KA supplementation. Results: After six months, serum albumin levels increased significantly (p < 0.001), while extracellular water (ECW) decreased (p = 0.024). Bioelectrical impedance analysis (BIA) also showed a significant increase in phase angle (PA; p = 0.029) and significant decreases in the extracellular mass-to-body cell mass ratio (ECM/BCM; p = 0.034) and the sodium-to-potassium ratio (Na/K; p = 0.025). The MIS also decreased significantly (p = 0.003). Conclusions: In this small retrospective study, six months of EAA/KA supplementation were associated with improvements in serum albumin, MIS, and several bioimpedance parameters in patients undergoing maintenance HD. These preliminary findings suggest a potential role for EAA/KA supplementation in the nutritional management of patients at nutritional risk. However, the small sample size, retrospective design, and absence of a control group limit the interpretation of these findings. Further prospective controlled studies involving larger populations are needed to confirm these observations.