Intradialytic Parenteral Nutrition in Malnourished Hemodialysis Patients: A Prospective Long‐Term Study

Mortelmans, Anna Katharina; Duym, Philippe; Vandenbroucke, Johan; Smet, Rita De; Dhondt, Annemieke; Lesaffer, Gerrit; Verwimp, Hans; Vanholder, Raymond

doi:10.1177/014860719902300290

Cited by 61 publications

(32 citation statements)

References 24 publications

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“…Parenteral provision of nutrients during HD (intradialytic parenteral nutrition [IDPN]) has been shown in many studies, including RCTs, to be a safe and convenient approach for individuals who cannot tolerate oral or enteral supplements, including those with overt PEW, although many studies had significant design flaws (55,56). In the largest nutritional intervention study in maintenance HD patients with PEW (FINE [French Intradialytic Nutrition Evaluation] study) (57), similar improvements of nutritional measures were observed in both the IDPN and oral nutritional supplementation groups, without differences in rates of hospitalization or death.…”

Section: Treatment Of Pew: An Integrated Approachmentioning

confidence: 99%

A Patient with CKD and Poor Nutritional Status

İkizler

2013

Clinical Journal of the American Society of Nephrology

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SummaryProtein energy wasting is common in patients with CKD and ESRD and is associated with adverse clinical outcomes, such as increased rates of hospitalization and death, in these patients. A multitude of factors can affect the nutritional and metabolic status of patients with CKD, including decreased dietary nutrient intake, catabolic effects of renal replacement therapy, systemic inflammation, metabolic and hormonal derangements, and comorbid conditions (such as diabetes and depression). Unique aspects of CKD also confound reliable assessment of nutritional status, further complicating management of this comorbid condition. In patients in whom preventive measures and oral dietary intake from regular meals cannot help them maintain adequate nutritional status, nutritional supplementation, administered orally, enterally, or parenterally, is effective in replenishing protein and energy stores. The advantages of oral nutritional supplements include proven efficacy, safety, and compliance. Anabolic steroids and exercise, with nutritional supplementation or alone, improve protein stores and represent potential additional approaches for the treatment of PEW. There are several emerging novel therapies, such as appetite stimulants, anti-inflammatory interventions, and anabolic agents.

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Section: Treatment Of Pew: An Integrated Approachmentioning

confidence: 99%

A Patient with CKD and Poor Nutritional Status

İkizler

2013

Clinical Journal of the American Society of Nephrology

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“…Their results also showed a significant increase in body weight and triceps skin fold when patients received IDPN as compared to the same patients before the therapy [11]. Similarly, a study by Cranford W. described an increase in BUN and albumin, and a decrease in hospitalization rate, length of stay, and the cost of hospitalization when patients received IDPN [12].…”

Section: Previous Studies and Their Shortcomingsmentioning

confidence: 88%

The Potential of Intradialytic Parenteral Nutrition: A Review

Pupim¹,

Kent²,

Hakim³

1999

Mineral Electrolyte Metab

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Malnutrition is common in chronic hemodialysis (CHD) patients and is strongly related to increased morbidity and mortality. Among the various approaches to treat malnutrition in this patient population, intradialytic parenteral nutrition (IDPN) is the treatment of choice for a small but important percentage of malnourished CHD patients. However, the new revised policies relating to IDPN reimbursement by Medicare in the US have made it very difficult to qualify patients for this potentially useful therapy. This restrictive policy was adopted mainly because there are no clear data that support IDPN use or efficacy. Studies to date in the literature do not provide clear documentation of the benefits of IDPN or their cost-effectiveness. The purpose of this review is to critically evaluate studies relating to the use of IDPN as a potential therapy to treat malnutrition in CHD patients and to discuss potential trials to prove its cost-effectiveness.

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“…Patients were subjected to long-term follow-up (i.e. more Prospective controlled long-term studies in malnourished HD patients using two-or three-component intradi-than 6 months) only in the studies of Capelli et [25,26,28,34,36,38,40]. Cellular immunity improved in three studies out of seven [25,36,40].…”

Section: Discussionmentioning

confidence: 99%

“…Few investigators atOlshan et al, 1987 [28] tempt to limit or to compensate for glucose and amino acid losses across the semipermeable dialysis membrane Olshan et al designed a prospective, uncontrolled trial. Ten ESRD patients were selected to receive IDPN, and [24,26,40]. Finally, most intradialytic parenteral nutrition studies have been restricted in time [28,32,34,[36][37][38], clinical and biochemical changes were monitored.…”

mentioning

confidence: 99%

Intradialytic Parenteral Nutrition in Malnourished Hemodialysis Patients. Review of the Literature

Mortelmans

Vanholder²

1999

Mineral Electrolyte Metab

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Malnutrition is a frequent problem of patients on intermittent hemodialysis and is associated with increased morbidity and mortality. Intradialytic parenteral nutrition (IDPN), i.e. intravenous supplementation of mixtures of glucose, amino acids and/or lipids during the hemodialysis session, is one of the therapeutic measures that are applied to correct this malnutrition. To our knowledge only few long-term clinical studies have been undertaken, evaluating the effect of intravenous calorie administration in hemodialysis. Most studies were carried out over a relatively short observation period in small study populations; in several of these studies, no measures were taken to prevent losses of nutrients in the dialysate; adequate control groups are often missing. The authors review the current available literature and conclude that IDPN might have a significant beneficial effect on the nutritional status in malnourished hemodialysis populations.

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Intradialytic Parenteral Nutrition in Malnourished Hemodialysis Patients: A Prospective Long‐Term Study

Cited by 61 publications

References 24 publications

A Patient with CKD and Poor Nutritional Status

A Patient with CKD and Poor Nutritional Status

The Potential of Intradialytic Parenteral Nutrition: A Review

Intradialytic Parenteral Nutrition in Malnourished Hemodialysis Patients. Review of the Literature

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