Use of parenteral nutrition in patients receiving isolated kidney or simultaneous pancreas/kidney transplantation.
BACKGROUND
There is little information available on the use of parenteral nutrition (PN) in patients after a kidney (KID) or simultaneous pancreas-kidney (SPK) transplantation. This study examined the indications and use of PN in these patients.


METHODS
Retrospective study of 25 patients (12M/13F; mean age: 51 +/- 11 years old) receiving PN after KID or SPK transplantation. Patients were divided in 2 groups according to the number of PN days (group A = <7 days and group B = >7 days).


RESULTS
Overall mortality was 16% (group A: 0/7; group B: 4/18). Postoperative ileus (n = 7), intestinal fistula (n = 5), and nausea/vomiting (n = 4) were the most common indications for PN. Functional disorders accounted for 56% (14/25) of the indications for PN. Factors differentiating group A (7/25; median = 5 [4-6] days) from group B (18/25; median =9 [7-31] days) included a significantly higher preoperative serum albumin, SPK transplantation for the first time, and diagnosis of ileus as the indication for PN initiation.


CONCLUSIONS
Functional disorders of the digestive tract are the primary reason for initiation of PN in isolated KID and SPK transplantation patients. Well-nourished patients undergoing their first SPK transplantation who develop postoperative ileus usually do not need nutrition intervention.
Sacks
Gordon S
GS
Division of Pharmacy Practice, School of Pharmacy, University of Wisconsin-Madison, 53705, USA. gssacks@pharmacy.wisc.edu
Aguilar-Nascimento
Jose E
JE
Kudsk
Kenneth A
KA
D005260:Female; D005402:Fistula / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D045823:Ileus / Q000453:epidemiology / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation; D010288:Parenteral Nutrition; D011182:Postoperative Care / Q000592:standards*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome