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

Savas Sipahi, Ozkan Gungor, Mehmet Gunduz, Mehmet Cilci, Mustafa Cahit Demirci, Ali Tamer, Savas Sipahi, Ozkan Gungor, Mehmet Gunduz, Mehmet Cilci, Mustafa Cahit Demirci, Ali Tamer

Abstract

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.

Figures

Figure 1
Figure 1
Pre-treatment and post-treatment wound appearances of the selected patients.

References

    1. Gupta A, Gupta P, Biyani M. Targeted therapies in diabetic nephropathy: an update. J Nephrol. 2011;24:686–695. doi: 10.5301/jn.5000041.
    1. 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.
    1. 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. doi: 10.1053/j.semvascsurg.2012.04.007.
    1. Demling RH. Nutrition, anabolism, and the wound healing process: an overview. Eplasty. 2009;9:65–94.
    1. 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. doi: 10.1007/s00726-008-0210-y.
    1. Miller AL. Therapeutic considerations of L-glutamine: a review of the literature. Altern Med Rev. 1999;4:239–248.
    1. 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.
    1. HMB (ß-hydroxy-ß-methylbutyrate): A scientific review. New Perspective on Lean Body Mass. .
    1. Williams JZ, Abumrad N, Barbul A. Effect of a specialized amino acid mixture on human collagen deposition. Ann Surg. 2002;236:369–374. doi: 10.1097/00000658-200209000-00013.
    1. Bates-Jensen B. New pressure ulcer status tool. Decubitus. 1990;3:14–15.
    1. Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA. 2005;293:217–228. doi: 10.1001/jama.293.2.217.
    1. 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. doi: 10.1093/ndt/gfn724.
    1. Sherman AR, Barkley M. Nutrition and wound healing. J Wound Care. 2011;20:357–358. 360, 362-367.
    1. Slater GJ, Jenkins D. Beta-hydroxy-beta-methylbutyrate (HMB) supplementation and the promotion of muscle growth and strength. Sports Med. 2000;30:105–116. doi: 10.2165/00007256-200030020-00004.
    1. 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. doi: 10.1016/j.biopha.2004.09.009.
    1. 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. doi: 10.1177/0148607103027003182.
    1. 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. doi: 10.1177/0148607100024003133.
    1. 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. doi: 10.1007/s00520-008-0403-7.
    1. Williams JZ, Barbul A. Nutrition and wound healing. Crit Care Nurs Clin North Am. 2012;24:179–200. doi: 10.1016/j.ccell.2012.03.001.
    1. 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.

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