Prolonged use of intradialysis parenteral nutrition in elderly malnourished chronic haemodialysis patients

Hiroshige, Kinya; Iwamoto, Masako; Kabashima, Narutoshi; Mutoh, Yoshinobu; Yuu, Kougi; Ohtani, Akira

doi:10.1093/ndt/13.8.2081

Cited by 57 publications

(51 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similar results have been reported by Navarro et al [12]. Also, Hisoshige et al [19], studied the parenteral infusion of a specific amino acid solution in 28 elderly malnourished chronic hemodialysis patients, for at least 2 years, and did not find any effect on the patients' metabolic acidosis. Specifically, they used Amiyu solution (Amiyu, Morishita CO, Tokyo, Japan), containing 14 gr of essential amino acids.…”

Section: Discussionsupporting

confidence: 77%

Effects of Parenteral Infusion of Amino Acid Solutions in Acid-Base Balance in Patients with Advanced Chronic Renal Failure

Kalogiannidou¹

2012

J Nephrol Therapeutic

View full text Add to dashboard Cite

Malnutrition is a very common condition in patients with chronic kidney disease (CKD), especially after the 3 rd stage (GFR 30-59 mL/min/1.73 m 2 ). It affects virtually every organ and the function of the entire organism as well and therefore influences the survival. Moreover, the supplementation of amino acids could correct the negative nitrogen balance of those patients improving their survival rates, while little is known regarding any possible negative effect of this supplementation of amino acids on the acid-base balance.We investigated the impact of parenteral infusion of two different kinds of amino acid solutions (specific for CKD patients and nonspecific) in 25 patients (12F, 13M), suffered from chronic renal failure in stages 3 and 4 (GFR 16 to 45.1 mL/min/1.73 m 2 ). The specific for uremic CKD patients solution A was administrated for 5 days, and after an interval of one week, we treated the same patients for another 5 days with the second non-specific solution B, with usual composition), in order to investigate their influence on patients' acid-base balance. Comparing the results of the first and the last infusion of solution A, neither pH nor blood gases analysis presented significant differences, while solution B induced statistically significant changes in both pH and blood gases, (p=0.0001). Acidosis was resulted in by the reduction of serum levels of HCO 3 -whereas not any significant change observed in serum lactate levels after the infusion of each solution.These results suggest that for patients with chronic kidney disease in stages 3 and 4 who require the administration of a supplementary amino acid solution, the CKD-specific solution A may be preferred, since it prevents the worsen of the metabolic acidosis, which is commonly present in these patients.

show abstract

Section: Discussionsupporting

confidence: 77%

Effects of Parenteral Infusion of Amino Acid Solutions in Acid-Base Balance in Patients with Advanced Chronic Renal Failure

Kalogiannidou¹

2012

J Nephrol Therapeutic

View full text Add to dashboard Cite

show abstract

“…Recent studies in humans on the effects of prolonged parenteral nutrition by intradialysis detected no changes in nutritional variables, particularly in anthropometric values, until after more than six months of therapy. [8,9] In addition, a study evaluating the acute effects of nutritional intervention in patients treated with PD did not demonstrate appreciable alterations in the serum albumin concentration. [10] In the present study, the turnover of plasma TP and Alb in the rats was more rapid than in humans, and these nutritional indexes did not change in comparison to the infused amino acid groups during the examination period.…”

Section: Discussionmentioning

confidence: 99%

New Peritoneal Dialysis Model in Rats with Bilateral Nephrectomy

et al. 2009

View full text Add to dashboard Cite

Many peritoneal dialysis (PD) patients with chronic renal failure (CRF) suffer from metabolic and nutritional abnormalities. However, these abnormalities have been not sufficiently investigated. At present, the resolution of these issues in this field has been hindered by the lack of suitable PD models. We attempt to develop a rat model of PD under no constraints and under nonanesthetization to evaluate amino acid solution as suitable nutritional therapy for renal failure. In our model, bilateral nephrectomy rats were dialyzed 6 h per day for three days. The dialysate was infused and removed continually via a metering pump. Under fasting, rats were infused with 5% glucose or amino acid solution for renal failure, and they remained alive. This model can be used to examine bilateral nephrectomy in rats for three or more days. We were also able to determine protein and calorie malnutrition, negative nitrogen balance, abnormalities in the plasma amino acid pattern, and calcium and phosphorus metabolism. Thus, this model has the characteristics of renal failure in humans and may be used to easily examine the metabolic changes due to loss of kidney function.

show abstract

“…Although IDPN did not have an additive effect to ONS in malnourished dialyzed patients [25], IDPN works to facilitate protein anabolism in patients receiving long-term hemodialysis in the acute phase [26]. This is evidenced by significant concomitant increases in lean body mass and albumin synthesis in the liver [27].…”

Section: Discussionmentioning

confidence: 98%

Questionnaire survey on nutritional supplement therapy and exercise training at hemodialysis facilities in Japan

et al. 2017

View full text Add to dashboard Cite

Background: Nutritional therapy and exercise training (ET) are important interventions for hemodialysis patients. We investigated the status of nutritional therapy and ET provided at hemodialysis facilities across Japan. Method: This was a cross-sectional study. The facilities investigated were 3993 facility member institutions of the Japanese Society for Dialysis Therapy in August 2015. Data was collected on the facility type, number of staff (doctors, nurses, and medic al engineers), presence of staff (clinical dietitians, pharmacists, and physical therapists), proportion of elderly patients (age ≥ 65 years), patients with albumin ≤ 3.5 g/dL, and types of oral nutritional supplements (ONS), intradialytic parenteral nutrition (IDPN), and ET in the facility. We summarized data on facilities and patient characteristics and calculated the proportion of the nutrition that were ONS, IDPN, and exercise interventions provided. We used multiple logistic analyses to examine the facility characteristics associated with the provision of nutritional support and ET. Results: We obtained responses from 1048 facilities (response rate 26.2%) and 88,492 patients (27.6%). Patients aged ≥ 65 years accounted for 63.4% of all investigated patients. Patients with Alb ≤ 3.5 g/dL accounted for 37.6% of all investigated patients. Meals during hemodialysis sessions were provided at 601 facilities (64%), ONS were used at 382 facilities (40%), and IDPN was administered at 471 facilities (46%). Exercise during hemodialysis sessions was provided at 190 facilities (20%). These trends did not change after adjustment of response rates by affiliations of facility type and region. At the patient level, only a limited number of patients were provided with ONS, IDPN, and ET, 2.1, 2.7, and 3.0%, respectively. ONS and IDPN were less likely to be offered in hospitals than in clinics without beds (odds ratio (OR) 0.21; 95% confidence interval (CI) 0.09-0.45) (OR 0.37; 95% CI 0.17-0.82). ET was also less likely to be offered in hospitals (OR 0.20; 95% CI 0.08-0.49). Conclusions: Nutritional support therapy is provided in a considerable number of hemodialysis facilities, ET is increasing but offered by fewer facilities compared to other countries, while a limited number of patients were provided with ET.

show abstract

Prolonged use of intradialysis parenteral nutrition in elderly malnourished chronic haemodialysis patients

Abstract: Prolonged use of IDPN prevents muscle protein catabolism and promotes body protein and fat accumulation. IDPN appears to be effective in malnourished elderly haemodialysis patients.

Cited by 57 publications

References 7 publications

Effects of Parenteral Infusion of Amino Acid Solutions in Acid-Base Balance in Patients with Advanced Chronic Renal Failure

Effects of Parenteral Infusion of Amino Acid Solutions in Acid-Base Balance in Patients with Advanced Chronic Renal Failure

New Peritoneal Dialysis Model in Rats with Bilateral Nephrectomy

Questionnaire survey on nutritional supplement therapy and exercise training at hemodialysis facilities in Japan

Contact Info

Product

Resources

About