Effect of intradialytic parenteral nutrition in patients with malnutrition–inflammation complex syndrome on body weight, inflammation, serum lipids and adipocytokines: results from a pilot study

Joannidis, Michael; Rauchenzauner, Markus; Leiner, B; Rosenkranz, Alexander R.; Ebenbichler, Christoph; Laimer, Markus; Tatarczyk, Tobias; Meusburger, Edgar; Mayer, Gert

doi:10.1038/sj.ejcn.1602777

Cited by 17 publications

(13 citation statements)

References 43 publications

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“…Improvements in overall protein balance improved in a randomized cross over study of 8 patients over 14 days [51] and also in another study which was open labeled and not controlled in 16 patients over 3 months [52]. The use of intradialytic parenteral nutrition (IDPN) solution in HD patients has also only been conducted in small studies, showing improvements in hepatic albumin synthesis and whole body fat free mass [53,54,55,56,57]. In the cross over study of 8 patients using both IDPN and oral supplements, the oral administration resulted in persistent anabolic benefits in the post dialysis phase, which was not seen with IDPN [55].…”

Section: Resultsmentioning

confidence: 99%

Nutrition Prescription to Achieve Positive Outcomes in Chronic Kidney Disease: A Systematic Review

et al. 2014

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In Chronic Kidney Disease (CKD), management of diet is important in prevention of disease progression and symptom management, however evidence on nutrition prescription is limited. Recent international CKD guidelines and literature was reviewed to address the following question “What is the appropriate nutrition prescription to achieve positive outcomes in adult patients with chronic kidney disease?” Databases included in the search were Medline and CINAHL using EBSCOhost search engine, Embase and the Cochrane Database of Systematic Reviews published from 2000 to 2009. International guidelines pertaining to nutrition prescription in CKD were also reviewed from 2000 to 2013. Three hundred and eleven papers and eight guidelines were reviewed by three reviewers. Evidence was graded as per the National Health and Medical Research Council of Australia criteria. The evidence from thirty six papers was tabulated under the following headings: protein, weight loss, enteral support, vitamin D, sodium, fat, fibre, oral nutrition supplements, nutrition counselling, including protein and phosphate, nutrients in peritoneal dialysis solution and intradialytic parenteral nutrition, and was compared to international guidelines. While more evidence based studies are warranted, the customary nutrition prescription remains satisfactory with the exception of Vitamin D and phosphate. In these two areas, additional research is urgently needed given the potential of adverse outcomes for the CKD patient.

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Section: Resultsmentioning

confidence: 99%

Nutrition Prescription to Achieve Positive Outcomes in Chronic Kidney Disease: A Systematic Review

et al. 2014

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“…IDPN refers to PN delivered during the hemodialysis procedure, typically by administering the nutrient admixture through the venous drip chamber of the dialysis circuit 4 . ‐ 7 The majority of the published data include patients with CKD receiving intermittent hemodialysis, although limited data exist for patients on peritoneal dialysis receiving dialysates enriched with amino acids 8 . ‐ 19 IDPN typically provides 500–1000 kcal and 50–100 g of amino acids in less than 1 L of volume per dialysis treatment.…”

Section: Question 7: In Which Patients Is Intradialytic Pn a Reasonabmentioning

confidence: 99%

“…Published data suggest that IDPN is generally safe and effective in improving nonfluid weight gain over time 8 . ‐ 17 However, these studies generally suffer from a few common limitations: the sample sizes in most reports are small (less than 30 patients); the frequency and intensity of hemodialysis are not described or standardized; and oral nutrient intake is not controlled and often not monitored.…”

Section: Question 7: In Which Patients Is Intradialytic Pn a Reasonabmentioning

confidence: 99%

When Is Parenteral Nutrition Appropriate?

Worthington

Balint

Bechtold

et al. 2017

J Parenter Enteral Nutr

180

202

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Parenteral nutrition (PN) represents one of the most notable achievements of modern medicine, serving as a therapeutic modality for all age groups across the healthcare continuum. PN offers a life-sustaining option when intestinal failure prevents adequate oral or enteral nutrition. However, providing nutrients by vein is an expensive form of nutrition support, and serious adverse events can occur. In an effort to provide clinical guidance regarding PN therapy, the Board of Directors of the American Society for Parenteral and Enteral Nutrition (ASPEN) convened a task force to develop consensus recommendations regarding appropriate PN use. The recommendations contained in this document aim to delineate appropriate PN use and promote clinical benefits while minimizing the risks associated with the therapy. These consensus recommendations build on previous ASPEN clinical guidelines and consensus recommendations for PN safety. They are intended to guide evidence-based decisions regarding appropriate PN use for organizations and individual professionals, including physicians, nurses, dietitians, pharmacists, and other clinicians involved in providing PN. They not only support decisions related to initiating and managing PN but also serve as a guide for developing quality monitoring tools for PN and for identifying areas for further research. Finally, the recommendations contained within the document are also designed to inform decisions made by additional stakeholders, such as policy makers and third-party payers, by providing current perspectives regarding the use of PN in a variety of healthcare settings. (JPEN J Parenter Enteral Nutr. 2017;41:324-377) The etiology-based nutrition diagnoses in adults in clinical practice settings are as follows: Starvation-related malnutrition: Chronic starvation without inflammation (eg, anorexia nervosa). Chronic disease-related malnutrition: Inflammation is chronicand of mild to moderate degree (eg, organ failure, pancreatic cancer, rheumatoid arthritis, sarcopenic obesity). Acute disease or injury-related malnutrition:Inflammation is acute and of severe degree (eg, major infection burns, trauma, closed head injury). 2,3Malnutrition, pediatric: An imbalance between nutrient requirement and intake, resulting in cumulative deficits of energy, protein, or micronutrients that may negatively affect growth, development, and other relevant outcomes. It is recommended that growth charts based on a standard deviation z score system be used to track and assess nutrition status in children. 4,5Nutritionally-at-risk: Consider the individual nutritionally-atrisk if any of the following is present. Nutritionally-At-Risk Adult Summary of RecommendationsThese consensus recommendations are designed to identify best practices, guide day-to-day clinical decisions, reduce variations in practice, and enhance patient safety. They are not intended to supersede the judgment of the healthcare professional based on the circumstances of the individual patient.

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“…It turned out that used supplementation caused the increase in BMI but did not significantly affect albumin concentration. Moreover, a decreased TNF-α secretion and slightly increased IL-6 level were observed [25].…”

Section: Resultsmentioning

confidence: 99%

“…Joannidis et al [25] assessed the effect of 6-month supplementation with nutrient preparations (Aminomel Nephro, Elolipid, L-carnitine and vitamin E) on the nutritional status and inflammatory parameters in patients treated with haemodialysis. It turned out that used supplementation caused the increase in BMI but did not significantly affect albumin concentration.…”

Section: Resultsmentioning

confidence: 99%

Clinical immunology Effect of diet on selected parameters of antioxidative system and inflammatory processes in patients dialyzed due to diabetic kidney disease

Bogacka¹,

Balejko²,

Bober³

et al. 2013

cejoi

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The aim of the study was to determine the effect of balanced diet on selected parameters of oxidative stress, immunological response and nutritional status in patients undergoing haemodialysis (HD) due to diabetic kidney disease. Forty HD patients took part in the study. The nutritional status and diets of all the patients were initially assessed and the patients were divided into two groups. The control group (C) got unchanged diet regarded by those patients as optimal. For patients in the P group, a standard diet for a patient undergoing haemodialysis treatment was introduced, considering the fundamental disease -diabetes. Albumin, total protein, leptin and interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) cytokine concentrations were determined in blood plasma, and CAT and SOD enzymes activity was determined in erythrocytes by

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Effect of intradialytic parenteral nutrition in patients with malnutrition–inflammation complex syndrome on body weight, inflammation, serum lipids and adipocytokines: results from a pilot study

Cited by 17 publications

References 43 publications

Nutrition Prescription to Achieve Positive Outcomes in Chronic Kidney Disease: A Systematic Review

Nutrition Prescription to Achieve Positive Outcomes in Chronic Kidney Disease: A Systematic Review

When Is Parenteral Nutrition Appropriate?

Clinical immunology Effect of diet on selected parameters of antioxidative system and inflammatory processes in patients dialyzed due to diabetic kidney disease

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