6129 INTRADIALYTIC PARENTERAL NUTRITION IMPROVES PROTEIN STORES IN CHRONIC HEMODIALYSIS PATIENTS

• Published in: Nephrology, dialysis, transplantation Vol. 38; no. Supplement_1
• Main Authors: Molina, Pablo, Quilis, Aina, Ureña, Paula Gandía, Saura, Laura Porcar, Llopis, Pilar, Parra, Manuel, Antón, Alejandro Valero, Barrilero, Elena Galván, Castillo, Belén Vizcaino, Moya, Mercedes González, Pérez-Boix, Gabriela, Rodrigo, María, Climente, Mónica, Calabuig, Maria Asuncion Sancho
• Format: Journal Article
• Language: English
• Published: 14.06.2023
• DOI: 10.1093/ndt/gfad063c_6129
• ISSN: 0931-0509

Abstract Background and Aims Intradialytic parenteral nutrition (IDPN) is a form of supplemental nutrition used to treat patients with malnutrition who receive hemodialysis (HD) and in which the oral feeding is not enough to cover basic caloric needs. Although this technique could improve biochemical markers of nutrition, information regarding its effect on body deposits is lacking. We evaluated the effect of IDPN on body composition parameters and nutritional status in prevalent HD patients. Method Retrospective observational study that included all prevalent hemodialysis patients who received NPID for more than 3 months at our Center from January 2018 to December 2022. All the patients received a concentrated 3-in-1 parenteral nutrition formula consisting of glucose solution, a lipid emulsion and an amino acid solution without electrolytes (OLIMEL N9®, Baxter). IDPN was infused at a constant rate not exceeding 300 ml/hour, via the venous drip chamber of HD monitor using infusion pump. Changes in lean tissue mass (LTM), intracellular water (ICW), and body cell mass (BCM) assessed by multifrequency bioimpedance spectroscopy (BIS) at baseline and at 3, 6, 9 and 12 months (primary outcomes) and other biochemical and anthropometric parameters (secondary outcomes) were used to assess the effect of NPID. Results Seventeen patients were included (women: 9, 53%; mean age: 68±15 y). After IDPN initiation, a gradual improvement in LTM, ICW and BCM was observed, reaching statistical significance at Month 3, 6, 9 and 12. Changes in fat inversely mirrored those of LTM (Table 1). Albumin levels and the normalized protein appearance increased, with a significant reduction in high-sensitive C-reactive protein and extracellular/intracellular body water ratio at month 9 and 12. Conclusion IDPN for 1-year was associated to increased muscle mass, supporting the hypothesis that this supplement nutrition could benefit nutritional status and revert protein-energy wasting in HD patients.