Intradialytic parenteral nutrition intervention boosts nutritional status in haemodialysis patients

An intradialytic parenteral nutrition (IDPN) program helps improve serum albumin, body weight, oral intake, and other nutritional indices in haemodialysis (HD) patients with protein-energy wasting (PEW), a recent study has found.

Researchers randomly assigned 38 HD patients (mean age 67.6 years) with PEW status to receive the IDPN intervention (n=18), which included a 3-in-1, fish oil-based parenteral nutrition infused during HD for 3 months, or to the control group (n=20), which received intensive dietary counselling weekly for 3 months. Participants were followed for 3 more months after the intervention.

Three months after enrolment, serum albumin levels showed a significantly higher increase in the IDPN group than in controls (from 3.5 to 3.8 g/dL vs from 3.6 to 3.5 g/dL, respectively; P=0.01). The change in serum albumin remained significantly better in the intervention arm even after adjusting for confounders.

Body weight likewise significantly increased after 3 months of IDPN (59.3 to 61.2 kg; p=0.006), whereas no such change was reported in controls (55.4 to 56.1 kg; p=0.22). A similar effect was reported for body mass index, though it only reached borderline significance (p=0.06).

Oral energy intake jumped by 281.2 kcal/day (p=0.001) at 3 months, while protein intake rose by 8.0 g/day (p=0.03) in the IDPN group. Meanwhile, spontaneous energy intake dropped significantly in controls (p=0.004). These improvements remained stable throughout the subsequent 3-month intervention-free phase.

“A significant improvement in spontaneous oral intake after IDPN supplementation was noted and this might be explained, in part, by changes in appetite-related biomarkers,” the researchers said.