Perdialytic parenteral nutrition with lipids and amino acids in malnourished hemodialysis patients.
A 3-mo perdialytic parenteral nutrition (PDPN) regimen was tested in 26 malnourished adults receiving hemodialysis (HD). Subjects were randomly assigned to receive PDPN (n = 12) or not to receive it (n = 14). PDPN was intravenously infused three times a week during HD; each infusion was made up of 1.6 g fat/kg body wt, 0.08 g N/kg body wt, essential and nonessential amino acids, and glycyl-tyrosine. PDPN, together with a PDPN-induced increase in spontaneous eating, increased intakes from 30 +/- 8.4 kcal.kg body wt-1.d-1 (mean +/- SD) and 1 +/- 0.27 g protein.kg body wt-1.d-1 to 39 +/- 8.5 kcal.kg body wt-1.d-1 and 1.25 +/- 0.30 g protein.kg body wt-1.d-1. Compared with control subjects, PDPN patients were characterized by increases in body weight (P less than 0.01), arm-muscle circumference (P less than 0.02), serum transthyretin and albumin concentrations (P less than 0.05), interdialytic creatinine appearance (P less than 0.01), skin-test reactivity (P less than 0.02), plasma leucine (P less than 0.05) without modifications of other amino acids, and plasma apolipoprotein A-I (P less than 0.01) without significant changes in apolipoprotein B, cholesterol, triglyceride, and phospholipid concentrations. Thus, PDPN appeared to be effective and safe with respect to plasma lipids.
Cano
N
N
Clinique de la Residence du Parc, Marseille, France.
Labastie-Coeyrehourq
J
J
Lacombe
P
P
Stroumza
P
P
di Costanzo-Dufetel
J
J
Durbec
J P
JP
Coudray-Lucas
C
C
Cynober
L
L
D000328:Adult; D000368:Aged; D000596:Amino Acids / Q000008:administration & dosage* / Q000097:blood; D006801:Humans; D008055:Lipids / Q000008:administration & dosage* / Q000097:blood; D008875:Middle Aged; D009748:Nutrition Disorders / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D009752:Nutritional Status; D010288:Parenteral Nutrition / Q000379:methods*; D006435:Renal Dialysis / Q000009:adverse effects
D000596:Amino Acids; D008055:Lipids