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. 2025 May 15;21(2):73-87.
doi: 10.1684/ndt.2025.117.

[Intradialytic parenteral nutrition: theory and practical application]

[Article in French]
Affiliations

[Intradialytic parenteral nutrition: theory and practical application]

[Article in French]
Céline Pasian et al. Nephrol Ther. .

Abstract

Protein energy wasting is common in chronic kidney disease at the dialysis stage. It has an impact on morbidity and mortality, and must be diagnosed and treated as early as possible. Various strategies can be envisaged, including dietary counseling, prescription of Oral Nutritional Supplements or artificial nutrition (enteral or parenteral nutrition). Intradialytic parenteral nutrition (IDPN) involves administering parenteral nutrition during hemodialysis sessions to support a moderate food intake deficit. In this article, a group of nephrologists, dieticians and nutrition physician the indications, non-indications, administration and monitoring of IDPN. In particular, they analyze IDPN infusion rates in relation to the maximum metabolic capacities of the various nutrients.

La dénutrition des patients dialysés impacte la morbi-mortalité et doit être diagnostiquée et traitée le plus tôt possible. Différentes stratégies peuvent être envisagées : le conseil diététique, la prescription de compléments nutritionnels oraux ou la nutrition artificielle (entérale ou parentérale). La nutrition parentérale perdialytique (NPPD) consiste à administrer une nutrition parentérale durant les séances d’hémodialyse afin de soutenir un déficit d’apport alimentaire modéré. Dans cet article, un groupe de professionnels associant diététiciens-nutritionnistes, néphrologues et un médecin nutritionniste propose de discuter les indications et les modalités pratiques pour l’initiation et le suivi de la NPPD, en se basant sur la littérature récente afin d’aider les professionnels des centres d’hémodialyse à mettre en œuvre cette technique de support nutritionnel pour leurs patients.

Keywords: chronic kidney disease; hemodialysis; protein energy wasting; undernutrition; parenteral nutrition; artificial nutrition; oral nutritional supplements.

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