An iso-osmolar oral supplement increases natriuresis and does not increase stomal output in patients with an ileostomy: A randomised, double-blinded, active comparator, crossover intervention study

Charlotte Rud; Anne Kathrine Nissen Pedersen; Trine Levring Wilkens; Mette Borre; Jens Rikardt Andersen; Hanne B Møller; Jens Frederik Dahlerup; Christian Lodberg Hvas

doi:10.1016/j.clnu.2018.10.014

An iso-osmolar oral supplement increases natriuresis and does not increase stomal output in patients with an ileostomy: A randomised, double-blinded, active comparator, crossover intervention study

Charlotte Rud, Anne Kathrine Nissen Pedersen, Trine Levring Wilkens, Mette Borre, Jens Rikardt Andersen, Hanne B Møller, Jens Frederik Dahlerup, Christian Lodberg Hvas^*

^*Corresponding author for this work

Nutrition and Health

Abstract

Background: Patients with an ileostomy often experience fluid and electrolyte depletion because of gastrointestinal loss. This study aimed to compare how an iso-osmolar and a hyperosmolar oral supplement affect ileostomy output, urine production, and natriuresis as proxy measurements of water-electrolyte balance.

Methods: In a randomised, double-blinded, active comparator, crossover intervention study, we included eight adult ileostomy patients who were independent of parenteral support. We investigated how an iso-osmolar (279 mOsm/kg) and a hyperosmolar (681 mOsm/kg) oral supplement affected ileostomy output mass, urine volume, and natriuresis. In addition to their habitual diet, each participant ingested 800 mL/day of either the iso-osmolar or hyperosmolar supplement in each of two study periods. Each period started with 24-hour baseline measurements, and the supplements were ingested during the following 48 h. All measurements were repeated in the last 24 h.

Results: No statistically significant changes in ileostomy output were detected following the intake of either oral supplement (median (range) 67 (-728 to 290) g/day, p = 0.25) despite increased fluid intake. Compared with the hyperosmolar supplement, the iso-osmolar supplement induced a statistically significant increase in urine volume (470 (0-780) mL/day, p = 0.02) and natriuresis (36 (0-66) mmol/day, p = 0.02).

Conclusion: Intake of the two oral supplements did not affect ileostomy output during this short intervention. Natriuresis increased following intake of the iso-osmolar supplement compared to that after ingesting the hyperosmolar supplement, indicating that patients with an ileostomy may benefit from increasing their ingestion of iso-osmolar fluids.

ClinicalTrials.gov identifier: NCT03348709.

Original language	English
Journal	Clinical Nutrition
Volume	38
Issue number	5
Pages (from-to)	2079-2086
Number of pages	8
ISSN	0261-5614
DOIs	https://doi.org/10.1016/j.clnu.2018.10.014
Publication status	Published - Oct 2019

Keywords

Faculty of Science
Ileostomy
Osmolality
Short bowel syndrome
Dehydration
Water-electrolyte balance
Natriuresis

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10.1016/j.clnu.2018.10.014

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Rud, C., Pedersen, A. K. N., Wilkens, T. L., Borre, M., Andersen, J. R., Møller, H. B., Dahlerup, J. F., & Hvas, C. L. (2019). An iso-osmolar oral supplement increases natriuresis and does not increase stomal output in patients with an ileostomy: A randomised, double-blinded, active comparator, crossover intervention study. Clinical Nutrition, 38(5), 2079-2086. https://doi.org/10.1016/j.clnu.2018.10.014

An iso-osmolar oral supplement increases natriuresis and does not increase stomal output in patients with an ileostomy : A randomised, double-blinded, active comparator, crossover intervention study. / Rud, Charlotte; Pedersen, Anne Kathrine Nissen; Wilkens, Trine Levring et al.

In: Clinical Nutrition, Vol. 38, No. 5, 10.2019, p. 2079-2086.

Research output: Contribution to journal › Journal article › Research › peer-review

Rud, C, Pedersen, AKN, Wilkens, TL, Borre, M, Andersen, JR, Møller, HB, Dahlerup, JF & Hvas, CL 2019, 'An iso-osmolar oral supplement increases natriuresis and does not increase stomal output in patients with an ileostomy: A randomised, double-blinded, active comparator, crossover intervention study', Clinical Nutrition, vol. 38, no. 5, pp. 2079-2086. https://doi.org/10.1016/j.clnu.2018.10.014

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title = "An iso-osmolar oral supplement increases natriuresis and does not increase stomal output in patients with an ileostomy: A randomised, double-blinded, active comparator, crossover intervention study",

abstract = "Background: Patients with an ileostomy often experience fluid and electrolyte depletion because of gastrointestinal loss. This study aimed to compare how an iso-osmolar and a hyperosmolar oral supplement affect ileostomy output, urine production, and natriuresis as proxy measurements of water-electrolyte balance.Methods: In a randomised, double-blinded, active comparator, crossover intervention study, we included eight adult ileostomy patients who were independent of parenteral support. We investigated how an iso-osmolar (279 mOsm/kg) and a hyperosmolar (681 mOsm/kg) oral supplement affected ileostomy output mass, urine volume, and natriuresis. In addition to their habitual diet, each participant ingested 800 mL/day of either the iso-osmolar or hyperosmolar supplement in each of two study periods. Each period started with 24-hour baseline measurements, and the supplements were ingested during the following 48 h. All measurements were repeated in the last 24 h.Results: No statistically significant changes in ileostomy output were detected following the intake of either oral supplement (median (range) 67 (-728 to 290) g/day, p = 0.25) despite increased fluid intake. Compared with the hyperosmolar supplement, the iso-osmolar supplement induced a statistically significant increase in urine volume (470 (0-780) mL/day, p = 0.02) and natriuresis (36 (0-66) mmol/day, p = 0.02).Conclusion: Intake of the two oral supplements did not affect ileostomy output during this short intervention. Natriuresis increased following intake of the iso-osmolar supplement compared to that after ingesting the hyperosmolar supplement, indicating that patients with an ileostomy may benefit from increasing their ingestion of iso-osmolar fluids. ClinicalTrials.gov identifier: NCT03348709.",

keywords = "Faculty of Science, Ileostomy, Osmolality, Short bowel syndrome, Dehydration, Water-electrolyte balance, Natriuresis",

author = "Charlotte Rud and Pedersen, {Anne Kathrine Nissen} and Wilkens, {Trine Levring} and Mette Borre and Andersen, {Jens Rikardt} and M{\o}ller, {Hanne B} and Dahlerup, {Jens Frederik} and Hvas, {Christian Lodberg}",

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doi = "10.1016/j.clnu.2018.10.014",

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TY - JOUR

T1 - An iso-osmolar oral supplement increases natriuresis and does not increase stomal output in patients with an ileostomy

T2 - A randomised, double-blinded, active comparator, crossover intervention study

AU - Rud, Charlotte

AU - Pedersen, Anne Kathrine Nissen

AU - Wilkens, Trine Levring

AU - Borre, Mette

AU - Andersen, Jens Rikardt

AU - Møller, Hanne B

AU - Dahlerup, Jens Frederik

AU - Hvas, Christian Lodberg

N1 - CURIS 2019 NEXS 318

PY - 2019/10

Y1 - 2019/10

N2 - Background: Patients with an ileostomy often experience fluid and electrolyte depletion because of gastrointestinal loss. This study aimed to compare how an iso-osmolar and a hyperosmolar oral supplement affect ileostomy output, urine production, and natriuresis as proxy measurements of water-electrolyte balance.Methods: In a randomised, double-blinded, active comparator, crossover intervention study, we included eight adult ileostomy patients who were independent of parenteral support. We investigated how an iso-osmolar (279 mOsm/kg) and a hyperosmolar (681 mOsm/kg) oral supplement affected ileostomy output mass, urine volume, and natriuresis. In addition to their habitual diet, each participant ingested 800 mL/day of either the iso-osmolar or hyperosmolar supplement in each of two study periods. Each period started with 24-hour baseline measurements, and the supplements were ingested during the following 48 h. All measurements were repeated in the last 24 h.Results: No statistically significant changes in ileostomy output were detected following the intake of either oral supplement (median (range) 67 (-728 to 290) g/day, p = 0.25) despite increased fluid intake. Compared with the hyperosmolar supplement, the iso-osmolar supplement induced a statistically significant increase in urine volume (470 (0-780) mL/day, p = 0.02) and natriuresis (36 (0-66) mmol/day, p = 0.02).Conclusion: Intake of the two oral supplements did not affect ileostomy output during this short intervention. Natriuresis increased following intake of the iso-osmolar supplement compared to that after ingesting the hyperosmolar supplement, indicating that patients with an ileostomy may benefit from increasing their ingestion of iso-osmolar fluids. ClinicalTrials.gov identifier: NCT03348709.

AB - Background: Patients with an ileostomy often experience fluid and electrolyte depletion because of gastrointestinal loss. This study aimed to compare how an iso-osmolar and a hyperosmolar oral supplement affect ileostomy output, urine production, and natriuresis as proxy measurements of water-electrolyte balance.Methods: In a randomised, double-blinded, active comparator, crossover intervention study, we included eight adult ileostomy patients who were independent of parenteral support. We investigated how an iso-osmolar (279 mOsm/kg) and a hyperosmolar (681 mOsm/kg) oral supplement affected ileostomy output mass, urine volume, and natriuresis. In addition to their habitual diet, each participant ingested 800 mL/day of either the iso-osmolar or hyperosmolar supplement in each of two study periods. Each period started with 24-hour baseline measurements, and the supplements were ingested during the following 48 h. All measurements were repeated in the last 24 h.Results: No statistically significant changes in ileostomy output were detected following the intake of either oral supplement (median (range) 67 (-728 to 290) g/day, p = 0.25) despite increased fluid intake. Compared with the hyperosmolar supplement, the iso-osmolar supplement induced a statistically significant increase in urine volume (470 (0-780) mL/day, p = 0.02) and natriuresis (36 (0-66) mmol/day, p = 0.02).Conclusion: Intake of the two oral supplements did not affect ileostomy output during this short intervention. Natriuresis increased following intake of the iso-osmolar supplement compared to that after ingesting the hyperosmolar supplement, indicating that patients with an ileostomy may benefit from increasing their ingestion of iso-osmolar fluids. ClinicalTrials.gov identifier: NCT03348709.

KW - Faculty of Science

KW - Ileostomy

KW - Osmolality

KW - Short bowel syndrome

KW - Dehydration

KW - Water-electrolyte balance

KW - Natriuresis

U2 - 10.1016/j.clnu.2018.10.014

DO - 10.1016/j.clnu.2018.10.014

M3 - Journal article

C2 - 30396772

SN - 0261-5614

VL - 38

SP - 2079

EP - 2086

JO - Clinical Nutrition

JF - Clinical Nutrition

IS - 5

ER -

An iso-osmolar oral supplement increases natriuresis and does not increase stomal output in patients with an ileostomy: A randomised, double-blinded, active comparator, crossover intervention study

Abstract

Keywords

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