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Intradialytic parenteral nutrition does not improve survival in malnourished hemodialysis patients: a 2-year multicenter, prospective, randomized study.
J Am Soc Nephrol. 2007 Sep; 18(9):2583-91.JA

Abstract

Although intradialytic parenteral nutrition (IDPN) is a method used widely to combat protein-calorie malnutrition in hemodialysis patients, its effect on survival has not been thoroughly studied. We conducted a prospective, randomized trial in which 186 malnourished hemodialysis patients received oral nutritional supplements with or without 1 year of IDPN. IDPN did not improve 2-year mortality (primary end point), hospitalization rate, Karnofsky score, body mass index, or laboratory markers of nutritional status. Instead, both groups demonstrated improvement in body mass index and the nutritional parameters serum albumin and prealbumin (P < 0.05). Multivariate analysis showed that an increase in prealbumin of >30 mg/L within 3 months, a marker of nutritional improvement, independently predicted a 54% decrease in 2-year mortality, as well as reduced hospitalizations and improved general well-being as measured by the Karnofsky score. Therefore, although we found no definite advantage of adding IDPN to oral nutritional supplementation, this is the first prospective study demonstrating that an improvement in prealbumin during nutritional therapy is associated with a decrease in morbidity and mortality in malnourished hemodialysis patients.

Authors+Show Affiliations

Service d'Hépatogastroenterologie et Nutrition, Clinique Résidence du Parc, Marseille, France. ncano@clermont.inra.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17656473

Citation

Cano, Noël J M., et al. "Intradialytic Parenteral Nutrition Does Not Improve Survival in Malnourished Hemodialysis Patients: a 2-year Multicenter, Prospective, Randomized Study." Journal of the American Society of Nephrology : JASN, vol. 18, no. 9, 2007, pp. 2583-91.
Cano NJ, Fouque D, Roth H, et al. Intradialytic parenteral nutrition does not improve survival in malnourished hemodialysis patients: a 2-year multicenter, prospective, randomized study. J Am Soc Nephrol. 2007;18(9):2583-91.
Cano, N. J., Fouque, D., Roth, H., Aparicio, M., Azar, R., Canaud, B., Chauveau, P., Combe, C., Laville, M., & Leverve, X. M. (2007). Intradialytic parenteral nutrition does not improve survival in malnourished hemodialysis patients: a 2-year multicenter, prospective, randomized study. Journal of the American Society of Nephrology : JASN, 18(9), 2583-91.
Cano NJ, et al. Intradialytic Parenteral Nutrition Does Not Improve Survival in Malnourished Hemodialysis Patients: a 2-year Multicenter, Prospective, Randomized Study. J Am Soc Nephrol. 2007;18(9):2583-91. PubMed PMID: 17656473.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intradialytic parenteral nutrition does not improve survival in malnourished hemodialysis patients: a 2-year multicenter, prospective, randomized study. AU - Cano,Noël J M, AU - Fouque,Denis, AU - Roth,Hubert, AU - Aparicio,Michel, AU - Azar,Raymond, AU - Canaud,Bernard, AU - Chauveau,Philippe, AU - Combe,Christian, AU - Laville,Maurice, AU - Leverve,Xavier M, AU - ,, Y1 - 2007/07/26/ PY - 2007/7/28/pubmed PY - 2007/11/14/medline PY - 2007/7/28/entrez SP - 2583 EP - 91 JF - Journal of the American Society of Nephrology : JASN JO - J. Am. Soc. Nephrol. VL - 18 IS - 9 N2 - Although intradialytic parenteral nutrition (IDPN) is a method used widely to combat protein-calorie malnutrition in hemodialysis patients, its effect on survival has not been thoroughly studied. We conducted a prospective, randomized trial in which 186 malnourished hemodialysis patients received oral nutritional supplements with or without 1 year of IDPN. IDPN did not improve 2-year mortality (primary end point), hospitalization rate, Karnofsky score, body mass index, or laboratory markers of nutritional status. Instead, both groups demonstrated improvement in body mass index and the nutritional parameters serum albumin and prealbumin (P < 0.05). Multivariate analysis showed that an increase in prealbumin of >30 mg/L within 3 months, a marker of nutritional improvement, independently predicted a 54% decrease in 2-year mortality, as well as reduced hospitalizations and improved general well-being as measured by the Karnofsky score. Therefore, although we found no definite advantage of adding IDPN to oral nutritional supplementation, this is the first prospective study demonstrating that an improvement in prealbumin during nutritional therapy is associated with a decrease in morbidity and mortality in malnourished hemodialysis patients. SN - 1046-6673 UR - https://www.unboundmedicine.com/medline/citation/17656473/Intradialytic_parenteral_nutrition_does_not_improve_survival_in_malnourished_hemodialysis_patients:_a_2_year_multicenter_prospective_randomized_study_ L2 - http://jasn.asnjournals.org/cgi/pmidlookup?view=long&amp;pmid=17656473 DB - PRIME DP - Unbound Medicine ER -