SUN-321 INVESTIGATING THE EFFECTIVENESS AND SAFETY OF A VERY LOW CALORIE DIET (VLCD) AS A METHOD OF WEIGHT LOSS IN PATIENTS RECEIVING HAEMODIALYSIS THERAPY.

Introduction: Very Low Calorie Diets (VLCD) have been demonstrated to achieve rapid and significant weight loss in obese people without kidney disease. However, there is no published evidence on the use of VLCD in end-stage kidney disease (ESKD) patients. Current manufacturers' guidelines state the meal replacement VLCD are contra-indicated in patients with impaired kidney function (eGFR <60ml/min). The aim of the study is to determine if the use of a VLCD with 3 meal replacements is safe and effective for weight loss in patients with ESKD treated with haemodialysis (HD). Method(s): 22 HD patients (9 home HD, 13 centre HD) with BMIs >30 were recruited and consented to the study. All were placed on a VLCD of 600-800 kcals. Subjects were monitored weekly for 4 weeks, and then fortnightly for the remainder of the study period (12 weeks in total). Pre and post dialysis weight, intradialytic fluid gain, biochemistry, ketones, and compliance with the VLCD plan were monitored each visit by nursing staff and dietitians. Dialysis prescriptions and medications were altered as medically required. Nutritional assessments, quality of life surveys, waist measurements, transthyretin and HbA1c were collected at baseline and completion of the study. Data was assessed using paired t-test and a mixed models where appropriate. All patients were included in the analysis. Result(s): Of the 22 patients recruited, 19 patients completed the 12 week treatment course. Three patients withdrew as they were found it difficult to maintain the study meal plans (at week 5, 6 and 10). Mean age was 49.7 years (SD 7.4), 40.1% were female, and 45.5% diabetic. Home HD patients were treated with alternate days HD 8 hours while centre HD were treated with 5 hour sessions 3 times per week. Mean pre dialysis weight was 121.1 kg (SD 28.4) at baseline. Throughout the study period pre-dialysis weight declined by 0.91 kg per week (95% C.I. 0.74 - 1.08, p<0.001). When assessed according to dialysis modality, rat