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Multicenter Study
. 2024 Nov 24;16(23):4018.
doi: 10.3390/nu16234018.

Intradialytic Parenteral Nutrition in Patients on Hemodialysis: A Multicenter Retrospective Study

Marta Arias-Guillén  1 , Juan Carlos González  2 , Loreley Betancourt  3 , Elisabeth Coll  4 , Silvia Collado  5 , Bárbara Romano-Andrioni  6 , Ascensión Lupiañez-Barbero  7 , Julia Garro  8 , Verónica Duarte  9 , Jordi Soler-Majoral  10 , Jordi Calabia  11
Affiliations
Multicenter Study

Intradialytic Parenteral Nutrition in Patients on Hemodialysis: A Multicenter Retrospective Study

Marta Arias-Guillén et al. Nutrients. .

Abstract

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.

Results: Fifty-six patients were included. The mean age was 72.4 ± 12.0 years, and 24 (42.9%) were women. In the overall study sample, MIS significantly decreased from 16.4 (95%CI: 15.3-17.65) at baseline to 14.3 (95%CI: 12.8-15.8) at the last follow-up visit on IDPN (p = 0.0019). Fifteen (26.8%) patients achieved a MIS reduction ≥ 5 points after IDPN. As compared to baseline, IDPN significantly reduced the proportion of patients with protein-energy wasting (PEW) (89.3% versus 66.1%, respectively, p = 0.0023). Regarding analytical parameters, serum albumin (p = 0.0003) and total proteins (p = 0.0024) significantly increased after IDPN administration. Throughout the study's follow-up period, 45 (80.4%) patients reported experiencing some type of adverse event.

Conclusions: IDPN was associated with a significant improvement in the nutritional profile. Notably, our research found that the administration of IDPN over a duration > 3 months significantly improved the nutritional status of patients evaluated by the MIS test.

Keywords: chronic kidney disease; hemodialysis; intradialytic parenteral nutrition; malnutrition inflammation score; protein-energy wasting.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of this study, in the collection, analysis, or interpretation of data, in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flow chart of the patients included in this study. IDPN: Intradialitic parenteral nutrition. Center 1: Hospital Clinic; Center 2: Hospital de Mollet; Center 3: Fundació Puigvert; Center 4: Hospital del Mar-Parc de Salut Mar; Center 5: Corporació Sanitaria Parc Taulí; Center 6: Hospital Universitari Dr. J Trueta; and Center 7: Hospital Universitari Joan XXIII.
Figure 2
Figure 2
Mean malnutrition inflammation score at baseline and at the last follow-up visit on intradialytic parenteral nutrition. Mean difference: −2.1 ± 4.8; 95% confidence interval: −3.5 to −8.0; p = 0.0019.
See this image and copyright information in PMC

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