title: Renal consequences of parenteral nutrition.
abstract: Parenteral nutrition (PN) can be described as the "Intravenous administration of nutrients necessary to sustain life in those who would otherwise have died or suffered serious disease". PN is indicated in children who cannot be fully fed by the oral or intestinal route, usually as a result of intestinal failure. Intradialytic parenteral nutrition (IDPN) is rarely indicated in children on dialysis and does not confer a benefit over enteral supplements in the compliant patient with adequate intestinal function. Renal and metabolic consequences of PN are potentially life-threatening and include disorders of glucose homeostasis, acid-base and fluid and electrolyte disturbances, nephrolithiasis, impaired renal function and metabolic bone disease. Many of these complications are avoidable. Adequate clinical and biochemical assessment and monitoring of children receiving PN by a multidisciplinary nutrition support team is recommended to mitigate against the risks of these complications.
authors.affiliation: Bristol Royal Hospital for Children, Bristol, BS355RT, United Kingdom, jan.dudley@nhs.net.
authors.forename: Jan
authors.initials: J
authors.lastname: Dudley
authors.forename: Rebekah
authors.initials: R
authors.lastname: Rogers
authors.forename: Laura
authors.initials: L
authors.lastname: Sealy
mesh_terms: D000818:Animals; D006801:Humans; D007668:Kidney / Q000378:metabolism / Q000503:physiopathology; D009752:Nutritional Status; D010288:Parenteral Nutrition / Q000009:adverse effects*; D018579:Patient Selection; D006435:Renal Dialysis / Q000009:adverse effects; D051437:Renal Insufficiency / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome