Effect of intradialytic parenteral nutrition in patients with malnutrition-inflammation complex syndrome on body weight, inflammation, serum lipids and adipocytokines: results from a pilot study.
OBJECTIVE
Evaluation of the influence of intradialytic parenteral nutrition (IDPN) in patients suffering from Malnutrition-Inflammation Complex Syndrome (MICS) on nutritional status, inflammation, adipocytokines and serum lipids.


METHODS
Six patients with MICS were assigned to IDPN, whereas six patients matched for age, sex, body mass index (BMI) and co-morbidity without malnutrition served as controls. Patients were recruited from Outpatient Dialysis Unit, Medical University Innsbruck and from Dialysis Unit, Hospital Feldkirch.


RESULTS
In all patients with IDPN, dry body weight increased during the interventional period whereas body weight remained stable in patients without IDPN. Tumor necrosis factor (TNF)-alpha levels were higher in patients with MICS compared with controls at all time points. Total cholesterol, LDL- and HDL-levels significantly increased during dialysis at all time points in controls but not in patients with MICS. Albumin, C-reactive protein, interleukin-6 (IL-6), soluble interleukin-2 receptor (sIL-2R) and adipocytokines did not differ between patients and controls during the study period.


CONCLUSIONS
IDPN in patients with MICS increases body weight despite not influencing inflammatory status. Furthermore, IDPN does not induce a pro-atherogenic lipid composition enhancing the risk for atherosclerosis. Thus, IDPN is a safe and effective treatment of malnutrition in patients with MICS.
Joannidis
M
M
Division of General Internal Medicine, Department of Internal Medicine, Medical University Innsbruck, Innsbruck, Austria. michael.joannidis@i-med.ac.at
Rauchenzauner
M
M
Leiner
B
B
Rosenkranz
A
A
Ebenbichler
C F
CF
Laimer
M
M
Tatarczyk
T
T
Meusburger
E
E
Mayer
G
G
D054392:Adipokines / Q000097:blood*; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000276:immunology / Q000628:therapy*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy; D008055:Lipids / Q000097:blood*; D008297:Male; D044342:Malnutrition / Q000097:blood / Q000628:therapy*; D009751:Nutritional Requirements; D009752:Nutritional Status; D010288:Parenteral Nutrition / Q000379:methods*; D010865:Pilot Projects; D011446:Prospective Studies; D006435:Renal Dialysis / Q000379:methods; D012709:Serum Albumin / Q000378:metabolism; D016896:Treatment Outcome; D015430:Weight Gain
D054392:Adipokines; D008055:Lipids; D012709:Serum Albumin; D002097:C-Reactive Protein; D002784:Cholesterol