Enabling intradialytic parenteral nutrition in maintenance haemodialysis patients in Malaysia

The what, who and how scenarios of implementation?

B. K. Sadu Singh, Abdul Halim Abdul Gafor, E. Fiaccadori, Tilakavati Karupaiah

Research output: Contribution to journalArticle

Abstract

In Malaysia, prevalence of end stage renal disease patients on haemodialysis has risen exponentially over the last 2 decades and malnutrition is significant in this population. In particular, protein energy wasting (PEW) is highly prevalent and associated with increased mortality and complications. Inadequate oral intake and poor appetite are implicated issues in the etiology of PEW. Intradialytic Parenteral Nutrition (IDPN) has been recommended by the International Society of Renal Nutrition and Metabolism as a treatment modality when dietary counselling and oral nutrition supplements fail to treat PEW in dialysis patients. IDPN does not require an additional infusion access and allows the delivery of nutrients during haemodialysis. IDPN practice protocols are now placed at different regions in the world. However, despite improved patient metabolic and nutritional status with IDPN, evidence linking IDPN with reduction in hospitalisation rates and mortality risk is limited. This review discusses IDPN composition and prescription, IDPN patient selection criteria, current available IDPN practice guidelines and the delivery of IDPN to haemodialysis patients. We conclude that IDPN is a potential adjunctive treatment strategy in the outpatient setting which is safe and efficacious for malnourished haemodialysis patients, when intensive dietary counselling and oral supplementation are compromised.

Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalMalaysian Applied Biology
Volume47
Issue number3
Publication statusPublished - 1 Jun 2018

Fingerprint

hemodialysis
Malaysia
Parenteral Nutrition
parenteral feeding
Renal Dialysis
Maintenance
diet counseling
mouth
Patient Selection
Counseling
energy
Nutrition Policy
Proteins
proteins
Mortality
Appetite
dialysis
appetite
kidney diseases
selection criteria

Keywords

  • Haemodialysis
  • Intradialytic parenteral nutrition
  • Protein energy wasting

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)

Cite this

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title = "Enabling intradialytic parenteral nutrition in maintenance haemodialysis patients in Malaysia: The what, who and how scenarios of implementation?",
abstract = "In Malaysia, prevalence of end stage renal disease patients on haemodialysis has risen exponentially over the last 2 decades and malnutrition is significant in this population. In particular, protein energy wasting (PEW) is highly prevalent and associated with increased mortality and complications. Inadequate oral intake and poor appetite are implicated issues in the etiology of PEW. Intradialytic Parenteral Nutrition (IDPN) has been recommended by the International Society of Renal Nutrition and Metabolism as a treatment modality when dietary counselling and oral nutrition supplements fail to treat PEW in dialysis patients. IDPN does not require an additional infusion access and allows the delivery of nutrients during haemodialysis. IDPN practice protocols are now placed at different regions in the world. However, despite improved patient metabolic and nutritional status with IDPN, evidence linking IDPN with reduction in hospitalisation rates and mortality risk is limited. This review discusses IDPN composition and prescription, IDPN patient selection criteria, current available IDPN practice guidelines and the delivery of IDPN to haemodialysis patients. We conclude that IDPN is a potential adjunctive treatment strategy in the outpatient setting which is safe and efficacious for malnourished haemodialysis patients, when intensive dietary counselling and oral supplementation are compromised.",
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