Oleh Admin Kalbe Medical pada October 04, 2017 07:30

Suplementasi BCAA Oral pada Pasien PGK dengan HD

Malnutrisi, yang sering ditemukan pada pasien lansia dengan hemodialisis kronik, bersifat multifaktorial, termasuk penuaan yang juga menjadi penyebabnya. Secara umum status nutrisi tergantung pada dosis dialisis yang diberikan, dan rendahnya efektivitas dialisis berhubungan dengan tingginya angka morbiditas dan mortalitas. Anoreksia cenderung menjadi faktor penyebab utama malnutrisi, khususnya pada pasien lansia.

Penelitian sebelumnya mengindikasikan kemungkinan hubungan antara kadar BCAA (Branch Chain Amino Acids) plasma dan nafsu makan. Dengan atau tanpa dialisis, profil asam amino plasma pada pasien gagal ginjal mengalami abnormalitas, seperti penurunan asam amino esensial/non-esensial dan rendahnya kadar BCAA. Oleh karena itu, pasien PGK dengan anoreksia bahkan sampai malnutrisi yang tidak berespons dengan terapi konvensional, seperti konseling nutrisi dan modifikasi diet, perlu diberikan suplementasi BCAA baik oral maupun parenteral. Anoreksia mungkin dapat berhubungan dengan penurunan kadar BCAA plasma.

Suatu penelitian dilakukan dengan tujuan untuk melihat efek pemberian suplemen BCAA oral pada pasien lansia yang menjalani dialisis. Metodenya adalah dengan mengumpulkan subjek yang memenuhi kriteria yaitu usia >70 tahun dan kadar albumin plasma <3,5 g/dL, sebanyak 14 pasien kemudian diacak menjadi 2 kelompok. Kelompok perlakuan diberi BCAA oral 12 g/hari selama 6 bulan dan kelompok kontrol hanya mendapatkan plasebo. Parameter yang dinilai adalah persentase lemak tubuh, lean body mass, konsentrasi albumin plasma, asupan protein dan kalori, dan profil asam amino plasma.

Hasilnya setelah 6 bulan pemberian terjadi peningkatan konsentrasi albumin plasma dari rata-rata 3,31 g/dL menjadi 3,93 g/dL pada kelompok perlakuan. Selain itu, juga terjadi perbaikan parameter nutrisi pada kelompok perlakuan dibandingkan dengan plasebo. Dari penelitian disimpulkan bahwa pemberian suplementasi BCAA oral dengan dosis 12 g/hari selama 6 bulan pada pasien lansia dengan dialisis dapat memperbaiki status nutrisi, yang dinilai dari peningkatan kadar albumin plasma. (LAI)

Image : Ilustrasi
Referensi:
1.Hiroshige K, Sonta T, Suda T, Kanegae K, Ohtani A. Oral supplementation of branched-chain amino acid improves nutritional status in elderly patients on chronic haemodialysis. Nephrol Dial Transplant. 2001;16(9):1856-62.
2.Nahid T, Niaz M. Emerging roles of branched-chain amino acid supplementation in human diseases. International Scholarly Research Notices. 2014;Article ID 235619:8.
3.Noe IJ, Cano M, Denis F, Xavier ML. Application of branched-chain amino acids in human pathological states: Renal failure. J Nutr. 2006;136:299–307.

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