The cost and bother of intradialytic parenteral nutrition are not justified by available scientific studies.
Intradialytic parenteral nutrition (IDPN) has been advocated for the management of malnutrition in hemodialysis patients. The rationale for its use is that patients are unable to increase oral intake to meet their nutritional needs or that the oral route is not effective in managing malnutrition in this group of patients. However, numerous studies using IDPN have failed to demonstrate efficacy conclusively with this very costly mode of treatment. This article reviews the literature evaluating the use of IDPN in the maintenance of hemodialysis patients and makes recommendations regarding the usefulness of various strategies to correct malnutrition in this patient population.
Wolfson
M
M
Portland VA Medical Center, OR 97201.
D006801:Humans; D009748:Nutrition Disorders / Q000628:therapy*; D010288:Parenteral Nutrition / Q000191:economics; D006435:Renal Dialysis / Q000191:economics