Intradialytic Parenteral Nutrition in Pediatrics

Abstract

Children with end-stage renal disease (ESRD) on hemodialysis are at increased risk for malnutrition. Aggressive nutrition intervention such as intradialytic parenteral nutrition (IDPN) should be considered to prevent further co-morbidities and mortality associated with malnutrition when other interventions fail. IDPN is a non-invasive method of providing nutrition to malnourished hemodialysis (HD) patients via the HD access throughout the HD treatment. Although the evidence on the long-term benefits of IDPN is scant in pediatrics, there is evidence that it improves metabolic parameters and nutritional status. In this paper, therapy with IDPN including indications, goals of therapy, and elements to monitor will be described. In addition, a practice guideline for prescribing IDPN is provided.

Assessment of nutritional status in children with kidney diseases—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce

“…Children receiving parenteral nutrition may additionally have specific micronutrient concerns (e.g., excess fat-soluble vitamins and inadequate water-soluble vitamin intake) that may require attention. However, few children with chronic kidney diseases receive chronic parenteral nutrition, except for a select group of HD patients who receive intradialytic parenteral nutrition (IDPN) [ 44 ]. Children who are vegetarian or vegan may need to be assessed more thoroughly for the risk of micronutrient deficiencies and the potential need for supplementation.…”

Uso de nutrición parenteral intradialítica: una revisión del Grupo de Estudio de Patología Renal de la Asociación Argentina de Nutrición Enteral y Parenteral

“…La glutamina es un AA Tabla 2. Monitorización de nutrientes y potenciales efectos adversos en NPID (9,(23)(24)(25)…”