{"id":{"repo_id":"uiuc","oai_identifier":"oai:www.ideals.illinois.edu:2142/89177"},"canonical_url":"https://search.dev.ndltd.org/etd/uiuc/oai:www.ideals.illinois.edu:2142/89177","repository":{"repo_id":"uiuc","name":"University of Illinois - Urbana-Champaign","base_url":"https://www.ideals.illinois.edu/oai-pmh"},"display":{"title":"Efficacy of beta-hydroxy-beta-methylbutyrate (HMB) supplementation in hemodialysis patients","abstract":"Patients with renal failure undergoing maintenance hemodialysis (MHD) therapy suffer from a number of co-morbidities including skeletal muscle loss, reduced physical function, a significantly increased fall risk, and reduced quality of life (QOL). Therefore, interventions to combat these co-morbidities are needed. Beta-hydroxy-beta-methylbutyrate (HMB) is a metabolite of the amino acid leucine that has been shown to improve lean mass and physical function in the elderly and clinical populations, but had not previously been studied in MHD patients. Approximately 25 percent of supplemental HMB is cleared by the kidney; therefore, we first performed an acute study to determine the clearance of supplemental HMB in hemodialysis patients. MHD patients (n=8) consumed 3g HMB prior to a standard hemodialysis session. Following supplementation with HMB, a majority of supplemental HMB was cleared within 48hrs and plasma HMB levels returned to baseline within 7 days in all participants. These results suggest that supplemental HMB is cleared in patients with impaired renal function. Based upon these results, we performed a double blind, placebo controlled, randomized trial to assess the effects of daily HMB supplementation on co-morbidities in MHD patients. MHD patients were recruited and assigned to either daily supplementation with HMB (n=16) or placebo (n=17) for 6 months. No significant effects of HMB on lean mass, strength, physical function, fall risk, or quality of life were found using an intent-to-treat analysis. However, upon analysis of plasma HMB concentrations, 5 of 16 patients (31%) who completed the study in the HMB group were found to be non-compliant at 3 or 6 months. Therefore, we performed a per-protocol analysis with compliant participants only. Although this analysis was underpowered, we observed a trend for improvements in chair stand and timed up-and-go tests with HMB supplementation. However, no effects of HMB were observed for lean mass, strength, fall risk, or quality of life. As a whole, these results do not support the efficacy of HMB to attenuate muscle loss and declines in physical function in MHD patients. However, the observed low-compliance with study pills may have affected results. Moreover, it highlights the need for future interventions targeted at reducing pill burden and improving pill compliance in this population.","abstract_html":"Patients with renal failure undergoing maintenance hemodialysis (MHD) therapy suffer from a number of co-morbidities including skeletal muscle loss, reduced physical function, a significantly increased fall risk, and reduced quality of life (QOL). Therefore, interventions to combat these co-morbidities are needed. Beta-hydroxy-beta-methylbutyrate (HMB) is a metabolite of the amino acid leucine that has been shown to improve lean mass and physical function in the elderly and clinical populations, but had not previously been studied in MHD patients. Approximately 25 percent of supplemental HMB is cleared by the kidney; therefore, we first performed an acute study to determine the clearance of supplemental HMB in hemodialysis patients. MHD patients (n=8) consumed 3g HMB prior to a standard hemodialysis session. Following supplementation with HMB, a majority of supplemental HMB was cleared within 48hrs and plasma HMB levels returned to baseline within 7 days in all participants. These results suggest that supplemental HMB is cleared in patients with impaired renal function. Based upon these results, we performed a double blind, placebo controlled, randomized trial to assess the effects of daily HMB supplementation on co-morbidities in MHD patients. MHD patients were recruited and assigned to either daily supplementation with HMB (n=16) or placebo (n=17) for 6 months. No significant effects of HMB on lean mass, strength, physical function, fall risk, or quality of life were found using an intent-to-treat analysis. However, upon analysis of plasma HMB concentrations, 5 of 16 patients (31%) who completed the study in the HMB group were found to be non-compliant at 3 or 6 months. Therefore, we performed a per-protocol analysis with compliant participants only. Although this analysis was underpowered, we observed a trend for improvements in chair stand and timed up-and-go tests with HMB supplementation. However, no effects of HMB were observed for lean mass, strength, fall risk, or quality of life. As a whole, these results do not support the efficacy of HMB to attenuate muscle loss and declines in physical function in MHD patients. However, the observed low-compliance with study pills may have affected results. Moreover, it highlights the need for future interventions targeted at reducing pill burden and improving pill compliance in this population.","abstract_has_math":false,"creators":["Fitschen, Peter J"],"institution":"University of Illinois at Urbana-Champaign","degree_name":"Ph.D.","degree_level":"Dissertation","degree_discipline":"Nutritional Sciences","degree_department":null,"school":null,"contributors":["Wilund, Kenneth R","Pan, Yuan-Xiang","Woods, Jeffrey A","Wilson, Jacob M"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2016,"date_issued":"2016-03-02T20:57:24Z","date_published":"2016-03-02T20:57:24Z","updated_at":"2026-07-22T22:26:32Z","subjects":["hemodialysis","muscle","kidney disease","end stage renal disease","Beta-hydroxy-beta-methylbutyrate (HMB)"],"languages":["en"],"rights":["Copyright 2015 Peter J. Fitschen"],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://hdl.handle.net/2142/89177","outbound_label":"Handle","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Wilund, Kenneth R","Pan, Yuan-Xiang","Woods, Jeffrey A","Wilson, Jacob M"]},{"key":"dc:creator","label":"Author","values":["Fitschen, Peter J"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2016-03-02T20:57:24Z","2018-03-03T10:15:09Z","2015-09-28","2015-12"]},{"key":"dc:type","label":"Dc Type","values":["text"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Nutritional Sciences"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Dissertation"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Ph.D."]},{"key":"thesis:institution_name","label":"Thesis Institution Name","values":["University of Illinois at Urbana-Champaign"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["hemodialysis","muscle","kidney disease","end stage renal disease","Beta-hydroxy-beta-methylbutyrate (HMB)"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["en"]},{"key":"dc:rights","label":"Dc Rights","values":["Copyright 2015 Peter J. Fitschen"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["http://hdl.handle.net/2142/89177"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["Patients with renal failure undergoing maintenance hemodialysis (MHD) therapy suffer from a number of co-morbidities including skeletal muscle loss, reduced physical function, a significantly increased fall risk, and reduced quality of life (QOL). Therefore, interventions to combat these co-morbidities are needed. Beta-hydroxy-beta-methylbutyrate (HMB) is a metabolite of the amino acid leucine that has been shown to improve lean mass and physical function in the elderly and clinical populations, but had not previously been studied in MHD patients. Approximately 25 percent of supplemental HMB is cleared by the kidney; therefore, we first performed an acute study to determine the clearance of supplemental HMB in hemodialysis patients. MHD patients (n=8) consumed 3g HMB prior to a standard hemodialysis session. Following supplementation with HMB, a majority of supplemental HMB was cleared within 48hrs and plasma HMB levels returned to baseline within 7 days in all participants. These results suggest that supplemental HMB is cleared in patients with impaired renal function. Based upon these results, we performed a double blind, placebo controlled, randomized trial to assess the effects of daily HMB supplementation on co-morbidities in MHD patients. MHD patients were recruited and assigned to either daily supplementation with HMB (n=16) or placebo (n=17) for 6 months. No significant effects of HMB on lean mass, strength, physical function, fall risk, or quality of life were found using an intent-to-treat analysis. However, upon analysis of plasma HMB concentrations, 5 of 16 patients (31%) who completed the study in the HMB group were found to be non-compliant at 3 or 6 months. Therefore, we performed a per-protocol analysis with compliant participants only. Although this analysis was underpowered, we observed a trend for improvements in chair stand and timed up-and-go tests with HMB supplementation. However, no effects of HMB were observed for lean mass, strength, fall risk, or quality of life. As a whole, these results do not support the efficacy of HMB to attenuate muscle loss and declines in physical function in MHD patients. However, the observed low-compliance with study pills may have affected results. Moreover, it highlights the need for future interventions targeted at reducing pill burden and improving pill compliance in this population.","Submission published under a 24 month embargo labeled 'Closed Access', the embargo will last until 2017-12-01","The student, Peter Fitschen, accepted the attached license on 2015-09-23 at 10:54.","The student, Peter Fitschen, submitted this Dissertation for approval on 2015-09-23 at 11:04.","This Dissertation was approved for publication on 2015-09-28 at 16:33.","DSpace SAF Submission Ingestion Package generated from Vireo submission #8696 on 2016-03-02 at 14:12:14","Made available in DSpace on 2016-03-02T20:57:24Z (GMT). No. of bitstreams: 3 FITSCHEN-DISSERTATION-2015.pdf: 1132318 bytes, checksum: 2f6920119bf744359df56acdc9606770 (MD5) FITSCHEN - Copyright Form.pdf: 247901 bytes, checksum: 16f7e3941414ee84f861a6dccc7e804b (MD5) LICENSE.txt: 4211 bytes, checksum: e80bb72c812b275ba4a3f47a62cdd922 (MD5) Previous issue date: 2015-09-28","Embargo set by: Seth Robbins for item 91379 Lift date: 2018-03-02T20:57:40Z Reason: Author requested closed access (OA after 2yrs) in Vireo ETD system","Embargo set by: Seth Robbins for item 91379 Lift date: 2018-03-02T21:07:27Z Reason: Author requested closed access (OA after 2yrs) in Vireo ETD system","Limited Restriction Lifted for Item 91379 on 2018-03-03T10:15:09Z."]},{"key":"dc:format","label":"Dc Format","values":["application/pdf"]},{"key":"dc:title","label":"Title","values":["Efficacy of beta-hydroxy-beta-methylbutyrate (HMB) supplementation in hemodialysis patients"]}]}],"canonical_facts":{"dc:contributor":["Wilund, Kenneth R","Pan, Yuan-Xiang","Woods, Jeffrey A","Wilson, Jacob M"],"dc:creator":["Fitschen, Peter J"],"dc:date":["2016-03-02T20:57:24Z","2018-03-03T10:15:09Z","2015-09-28","2015-12"],"dc:description":["Patients with renal failure undergoing maintenance hemodialysis (MHD) therapy suffer from a number of co-morbidities including skeletal muscle loss, reduced physical function, a significantly increased fall risk, and reduced quality of life (QOL). Therefore, interventions to combat these co-morbidities are needed. Beta-hydroxy-beta-methylbutyrate (HMB) is a metabolite of the amino acid leucine that has been shown to improve lean mass and physical function in the elderly and clinical populations, but had not previously been studied in MHD patients. Approximately 25 percent of supplemental HMB is cleared by the kidney; therefore, we first performed an acute study to determine the clearance of supplemental HMB in hemodialysis patients. MHD patients (n=8) consumed 3g HMB prior to a standard hemodialysis session. Following supplementation with HMB, a majority of supplemental HMB was cleared within 48hrs and plasma HMB levels returned to baseline within 7 days in all participants. These results suggest that supplemental HMB is cleared in patients with impaired renal function. Based upon these results, we performed a double blind, placebo controlled, randomized trial to assess the effects of daily HMB supplementation on co-morbidities in MHD patients. MHD patients were recruited and assigned to either daily supplementation with HMB (n=16) or placebo (n=17) for 6 months. No significant effects of HMB on lean mass, strength, physical function, fall risk, or quality of life were found using an intent-to-treat analysis. However, upon analysis of plasma HMB concentrations, 5 of 16 patients (31%) who completed the study in the HMB group were found to be non-compliant at 3 or 6 months. Therefore, we performed a per-protocol analysis with compliant participants only. Although this analysis was underpowered, we observed a trend for improvements in chair stand and timed up-and-go tests with HMB supplementation. However, no effects of HMB were observed for lean mass, strength, fall risk, or quality of life. As a whole, these results do not support the efficacy of HMB to attenuate muscle loss and declines in physical function in MHD patients. However, the observed low-compliance with study pills may have affected results. Moreover, it highlights the need for future interventions targeted at reducing pill burden and improving pill compliance in this population.","Submission published under a 24 month embargo labeled 'Closed Access', the embargo will last until 2017-12-01","The student, Peter Fitschen, accepted the attached license on 2015-09-23 at 10:54.","The student, Peter Fitschen, submitted this Dissertation for approval on 2015-09-23 at 11:04.","This Dissertation was approved for publication on 2015-09-28 at 16:33.","DSpace SAF Submission Ingestion Package generated from Vireo submission #8696 on 2016-03-02 at 14:12:14","Made available in DSpace on 2016-03-02T20:57:24Z (GMT). No. of bitstreams: 3 FITSCHEN-DISSERTATION-2015.pdf: 1132318 bytes, checksum: 2f6920119bf744359df56acdc9606770 (MD5) FITSCHEN - Copyright Form.pdf: 247901 bytes, checksum: 16f7e3941414ee84f861a6dccc7e804b (MD5) LICENSE.txt: 4211 bytes, checksum: e80bb72c812b275ba4a3f47a62cdd922 (MD5) Previous issue date: 2015-09-28","Embargo set by: Seth Robbins for item 91379 Lift date: 2018-03-02T20:57:40Z Reason: Author requested closed access (OA after 2yrs) in Vireo ETD system","Embargo set by: Seth Robbins for item 91379 Lift date: 2018-03-02T21:07:27Z Reason: Author requested closed access (OA after 2yrs) in Vireo ETD system","Limited Restriction Lifted for Item 91379 on 2018-03-03T10:15:09Z."],"dc:format":["application/pdf"],"dc:identifier":["http://hdl.handle.net/2142/89177"],"dc:language":["en"],"dc:rights":["Copyright 2015 Peter J. Fitschen"],"dc:subject":["hemodialysis","muscle","kidney disease","end stage renal disease","Beta-hydroxy-beta-methylbutyrate (HMB)"],"dc:title":["Efficacy of beta-hydroxy-beta-methylbutyrate (HMB) supplementation in hemodialysis patients"],"dc:type":["text"],"thesis:degree_discipline":["Nutritional Sciences"],"thesis:degree_level":["Dissertation"],"thesis:degree_name":["Ph.D."],"thesis:institution_name":["University of Illinois at Urbana-Champaign"]},"updated_at":"2026-07-22T22:26:32Z"}