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Intradialytic parenteral nutrition in end-stage renal disease: practical aspects, indications and limits.
J Nephrol 2014; 27(4):377-83JN

Abstract

Protein-energy malnutrition (PEW) is highly prevalent in patients with end-stage renal disease (ESRD) and is associated with a significant increase of the already high mortality and morbidity risk typical of this clinical setting. Since a key mechanism of PEW in ESRD is inadequate nutrient intake, oral nutritional supplements are extensively employed, and have been demonstrated to be highly effective in PEW prevention and treatment. Intradialytic parenteral nutrition (IDPN), i.e. the administration of nutrients through the extracorporeal circuit during hemodialysis, has also been proposed as a modality of nutritional support for patients with ESRD. However, even though metabolic/nutritional status is improved by this nutritional approach, the evidence linking IDPN to decreased hospitalization rate and lower mortality risk is still scant. The aim of the present paper is to review the role of IDPN as a modality of nutritional supplementation for ESRD patients on hemodialysis. To this end, quantitative and qualitative aspects, practical management, the indications, and limits of IDPN are discussed. On the basis of the available evidence, it is suggested that IDPN is a safe and efficacious modality of nutritional support in ESRD, and could represent an adjunctive strategy for patients with reduced spontaneous dietary intake when intensive dietetic counseling and oral supplementation have failed.

Authors+Show Affiliations

Renal Unit, Department of Clinical and Experimental Medicine, Parma University Medical School, Parma, Italy, alice.sabatino@gmail.com.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

24557877

Citation

Sabatino, Alice, et al. "Intradialytic Parenteral Nutrition in End-stage Renal Disease: Practical Aspects, Indications and Limits." Journal of Nephrology, vol. 27, no. 4, 2014, pp. 377-83.
Sabatino A, Regolisti G, Antonucci E, et al. Intradialytic parenteral nutrition in end-stage renal disease: practical aspects, indications and limits. J Nephrol. 2014;27(4):377-83.
Sabatino, A., Regolisti, G., Antonucci, E., Cabassi, A., Morabito, S., & Fiaccadori, E. (2014). Intradialytic parenteral nutrition in end-stage renal disease: practical aspects, indications and limits. Journal of Nephrology, 27(4), pp. 377-83. doi:10.1007/s40620-014-0051-6.
Sabatino A, et al. Intradialytic Parenteral Nutrition in End-stage Renal Disease: Practical Aspects, Indications and Limits. J Nephrol. 2014;27(4):377-83. PubMed PMID: 24557877.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intradialytic parenteral nutrition in end-stage renal disease: practical aspects, indications and limits. AU - Sabatino,Alice, AU - Regolisti,Giuseppe, AU - Antonucci,Elio, AU - Cabassi,Aderville, AU - Morabito,Santo, AU - Fiaccadori,Enrico, Y1 - 2014/02/21/ PY - 2013/08/28/received PY - 2013/11/16/accepted PY - 2014/2/22/entrez PY - 2014/2/22/pubmed PY - 2015/7/15/medline SP - 377 EP - 83 JF - Journal of nephrology JO - J. Nephrol. VL - 27 IS - 4 N2 - Protein-energy malnutrition (PEW) is highly prevalent in patients with end-stage renal disease (ESRD) and is associated with a significant increase of the already high mortality and morbidity risk typical of this clinical setting. Since a key mechanism of PEW in ESRD is inadequate nutrient intake, oral nutritional supplements are extensively employed, and have been demonstrated to be highly effective in PEW prevention and treatment. Intradialytic parenteral nutrition (IDPN), i.e. the administration of nutrients through the extracorporeal circuit during hemodialysis, has also been proposed as a modality of nutritional support for patients with ESRD. However, even though metabolic/nutritional status is improved by this nutritional approach, the evidence linking IDPN to decreased hospitalization rate and lower mortality risk is still scant. The aim of the present paper is to review the role of IDPN as a modality of nutritional supplementation for ESRD patients on hemodialysis. To this end, quantitative and qualitative aspects, practical management, the indications, and limits of IDPN are discussed. On the basis of the available evidence, it is suggested that IDPN is a safe and efficacious modality of nutritional support in ESRD, and could represent an adjunctive strategy for patients with reduced spontaneous dietary intake when intensive dietetic counseling and oral supplementation have failed. SN - 1724-6059 UR - https://www.unboundmedicine.com/medline/citation/24557877/Intradialytic_parenteral_nutrition_in_end_stage_renal_disease:_practical_aspects_indications_and_limits_ L2 - https://dx.doi.org/10.1007/s40620-014-0051-6 DB - PRIME DP - Unbound Medicine ER -