A Case Report: Intradialytic Parenteral Nutrition in Hemodialysis Patient

Abstract

End Stage Renal Disease (ESRD) is characterized with irreversible loss of renal functions and this constitutes a clinical state that requires renal replacement treatments such as hemodialysis, continuous ambulatory peritoneal dialysis and transplantation in order to be protected from harmful and life threatening effects of uremia. Malnutrition rates of the hemodialysis and continuous ambulatory peritoneal dialysis patients are 18-75% and 10-50%, respectively. Periodic assessment of nutritional status should be part of the routine care of dialysis patients to permit early recognition and the institution of appropriate therapy. The first step is to modify the diet for each individual, and increase oral food intake. Nutritional support must be recommended in undernourished ESRD patients as defined by low nutritional indices, mainly body mass index less than 20 kg/m2, body weight loss more than 10% over 6 months, serum albumin less than 3.5 g/dL and serum prealbumin less than 30 mg/dL and in cases where normal food intake is inadequate. Oral nutritional supplement (ONS) is suggested in patiens in addition to diet therapy. If the patients can’t tolerate ONS, intradialytic parenteral nutrition in hemodialysisis is recommended. If ONS and IDPN is not well tolerated, enteral tube feeding should be offered In this case report we discussed via a case strategies of intradialytic parenteral nutrition in hemodialysis patient.