Intradialytic parenteral nutrition and intraperitoneal nutrition are methods to provide supplemental nutrition support to patients with chronic kidney disease (also referred to as end-stage renal disease) while they are receiving dialytic therapy. There has been considerable controversy over indications and benefits of intradialytic parenteral nutrition and intraperitoneal nutrition. A major stumbling block had been problematic reimbursement for the therapy under Medicare. Medicare Part D has alleviated some of the reimbursement obstacles and has increased interest in reexamining the benefits and burdens of supplemental nutrition support therapies for patients receiving dialysis.
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Intradialytic Parenteral Nutrition in Patients on Hemodialysis: A Multicenter Retrospective Study.
Nutrients
November 2024
Nephrology Department, Hospital Universitari Dr. J Trueta, 17007 Girona, Spain.
Background And Objective: To evaluate the effectiveness and safety of intradialytic parenteral nutrition (IDPN) on different nutritional outcomes.
Methods: This was a retrospective analysis for a "routinely collected data bank" in a multicenter cohort, conducted on consecutive malnourished or at-risk of malnutrition patients with chronic kidney disease on hemodialysis who underwent IDPN with a three-in-one parenteral nutrition formula for a period ≥ 2 weeks. The primary endpoint was the mean change in the malnutrition inflammation score (MIS) score between baseline and the last follow-up visit on IDPN.
Efficacy and safety of intradialytic parenteral nutrition using ENEFLUID® in malnourished patients receiving maintenance hemodialysis: An exploratory, multicenter, randomized, open-label study.
PLoS One
December 2024
Department of Nephrology, Tokyo Medical University, Shinjuku, Tokyo, Japan.
The objective of this study was to investigate the efficacy and safety of intradialytic parenteral nutrition (IDPN) using ENEFLUID® (310 kcal, 550 mL) in mild-moderate malnutrition patients receiving maintenance hemodialysis. A total of 40 adult patients with a Nutritional Risk Index-Japanese Hemodialysis (NRI-JH) score of 5-10 were enrolled in this multicenter, randomized, open-label study. Patients in the intervention group received IDPN using ENEFLUID® via the dialysis circuit 3 times a week for 12 weeks; those in the control group did not.
View Article and Find Full Text PDFA roadmap for implementing a successful clinical experience with intradialytic parenteral nutrition.
Clin Nutr ESPEN
October 2024
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
Article Synopsis
- Intradialytic parenteral nutrition (IDPN) is an effective nutritional strategy for malnourished patients on hemodialysis, especially those who haven’t responded well to standard dietary methods.
- Current guidelines for IDPN lack practical implementation strategies, which has limited its usage in clinical settings.
- This review offers a comprehensive roadmap covering when to start IDPN, what nutrients to include, administration methods, monitoring effectiveness, and conditions for discontinuation to enhance nutritional care for hemodialysis patients.
Revisiting Intradialytic Parenteral Nutrition: How Can We Apply the Evidence in Clinical Practice?
Adv Kidney Dis Health
November 2023
Northland Renal Service, Whangarei Hospital, Whangarei, New Zealand.
Intradialytic parenteral nutrition (IDPN) remains a controversial nutrition support practice in hemodialysis. Multiple reviews and evidence-based clinical practice guidelines have been published in the past 20 years. Despite essentially looking at the same evidence, conclusions and recommendations vary significantly, leading to widespread uncertainty among clinicians on the value of and indications for IDPN.
View Article and Find Full Text PDFNutrition Support for Older Adults With Pressure Injuries Receiving Maintenance Hemodialysis: A Case Study.
J Ren Nutr
May 2024
Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers University, Newark, New Jersey; Professor, Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers University, Newark, New Jersey. Electronic address:
Hemodialysis (HD) and pressure injuries (PI) are both hypercatabolic states that may contribute to protein-energy wasting development. These conditions require increased energy and protein to prevent losses from HD and support wound healing. Nutrition support therapy using intradialytic parenteral nutrition (IDPN) with or without a combination of oral nutrition supplements has yielded positive outcomes among patients receiving HD with protein-energy wasting.
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