| Abstrakt: |
Introduction: Malnutrition in hemodialysis is a powerful predictor of morbidity and mortality. Intradialytic parenteral nutrition is widely employed to treat malnourished hemodialysis patients, though insufficient evidence supports its benefits. The aim of our work was to analyze intradialytic parenteral nutrition effects on malnourished hemodialysis patients. Materials and methods: A total of 21 patients (14 males and 7 females, mean age 67±16 years, dry weight 57±13 kg, body mass index [BMI] 20±4 kg/m²) received personalized intradialytic parenteral nutrition bags during each dialysis session for at least 4 months. Characteristics of the bags were: volume 600-1,000 mL, glucides 70-130 g, proteins 40-50 g, lipids 20-40 g, energy 600-1,000 Kcal. Before and after parenteral nutrition we evaluated: dry-weight, BMI, results of a nutritional blood test (proteins, albumin, phosphates), energy and nutrients’ intakes in the whole group and in 3 subgroups (Gr1 and Gr2) defined according to the Δ weight obtained (Gr1>+1 kg, Gr2=±1 kg, Gr3<-1 kg). Results: Both the mean patients’ body weight (Δ=+0.1±3 kg) and BMI (Δ=+0.03±1.04 kg/m²) remained stable or did not worsen. Five patients (24%) had an increased body weight (+4.1±3.2 kg), 7 (33%) remained stable, while 9 patients (43%) lost a mean of 1.9±1.4 kg. The results of the nutritional blood tests slightly improved after parenteral nutrition and the mean energy and protein intakes significantly improved (+488±508 Kcal, +21±22 g/die, p<0.001), especially in Gr1, but also in Gr3 (despite for Gr3 the nutritional goals were not fulfilled). Conclusions: After parenteral nutrition, patients showed a decrease in anorexia-asthenia with an increase in food/nutritional intakes. Body weight and serum albumin did not worsen. Intradialytic parenteral nutrition seems positive on subjective well-being and anorexia. However, more studies are needed on larger groups. [ABSTRACT FROM AUTHOR] |
