The use of intradialytic parenteral nutrition in acutely ill haemodialysed patients.
BACKGROUND
Protein/caloric malnutrition is a problem in chronically haemodialysed patients, and is an independent risk factor for increased mortality in these patients.


OBJECTIVE
To assess the safety and efficiency of intradialytic parenteral nutritional (IDPN) as nutritional support in acutely ill haemodialysis patients.


METHODS
Twenty-two haemodialysis patients received IDPN after either major surgical or medical illnesses. Parameters measured included possible complications of IDPN, dialysis adequacy, patients' weight, protein catabolic rate (PCR) and serum levels of albumin, pre-albumin, creatinine, cholesterol, c-reactive protein (c-RP) and haemoglobin. After the end of the study all patients were followed-up for a further 6 months.


RESULTS
Patients received IDPN for 1.5-48 months. Eighteen patients received IDPN <6 months. IDPN was safe for all patients. Throughout this period dialysis remained adequate. Weight loss in all patients ceased after approximately 2 months of IDPN. PRC, serum albumin, pre-albumin, cholesterol and creatinine levels all increased significantly. c-RP dropped from 77+/-86 mg/l to 9+/-10 mg/l.


CONCLUSIONS
IDPN can be safely used in haemodialysed patients who are acutely ill and are unable to meet daily nutritional requirements with an oral intake. All studied parameters of nutrition and inflammation improved significantly while patients were treated with IDPN.
Korzets
Asher
A
Department of Nephrology, Hasharon Hospital, Rabin Medical Center, Petach Tikva, Israel.
Azoulay
Odile
O
Ori
Yaacov
Y
Zevin
Dina
D
Boaz
Mona
M
Herman
Michal
M
Chagnac
Avri
A
Gafter
Uzi
U
D000208:Acute Disease; D000368:Aged; D002784:Cholesterol / Q000097:blood; D003404:Creatinine / Q000097:blood; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009751:Nutritional Requirements; D009752:Nutritional Status; D010288:Parenteral Nutrition / Q000009:adverse effects / Q000379:methods*; D011228:Prealbumin / Q000378:metabolism; D011446:Prospective Studies; D011502:Protein-Energy Malnutrition / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism / Q000628:therapy*; D006435:Renal Dialysis / Q000379:methods; D012449:Safety; D012709:Serum Albumin / Q000378:metabolism; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome
D006454:Hemoglobins; D011228:Prealbumin; D012709:Serum Albumin; D002784:Cholesterol; D003404:Creatinine