Nutrizione parenterale intradialitica in pazienti con malnutrizione moderata-severa: studio prospettico osservazionale multicentrico

Concetto Sessa; Walter Morale; Antonino Reina; Giorgio Battaglia; Sandra La Rosa; Daniela Puliatti; Giuseppe Seminara; Luca Zanoli

doi:10.33393/gcnd.2021.2335

Authors

Concetto Sessa U.O.C. Nefrologia e Dialisi, P.O. “Maggiore” di Modica, Ragusa - Italy https://orcid.org/0000-0002-9144-0647
Walter Morale U.O.C. Nefrologia e Dialisi, P.O. “Maggiore” di Modica, Ragusa - Italy
Antonino Reina U.O.C. Nefrologia e Dialisi, P.O. S. Marta e S. Venera, Acireale (CT) - Italy
Giorgio Battaglia U.O.C. Nefrologia e Dialisi, P.O. S. Marta e S. Venera, Acireale (CT) - Italy
Sandra La Rosa U.O. Nefrologia e Dialisi, P.O. “Giovanni Paolo II” Sciacca, Agrigento - Italy
Daniela Puliatti U.O.C. Nefrologia, A.O. per l’Emergenza “Cannizzaro”, Catania - Italy
Giuseppe Seminara U.O.C. Nefrologia, A.O. per l’Emergenza “Cannizzaro”, Catania - Italy
Luca Zanoli Nefrologia, Dipartimento di Medicina Clinica e Sperimentale, Università di Catania, Catania - Italy

DOI:

https://doi.org/10.33393/gcnd.2021.2335

Keywords:

Dialysis, Intradialytic parenteral nutrition, Malnutrition, Nutritional supplementation, Protein energy wasting

Abstract

Dialysis patients have a wide range of pathologies that contribute to their frailty. Maintaining a good nutritional status is useful to prevent and treat the so-called Protein-Energy Wasting (PEW), a complex clinical-laboratory condition in which a protein-energy depletion occurs. Adherence to a proper nutritional therapy in CKD requires considerable effort from both patients and health personnel (doctors and nurses). In order to slow down the effects of malnutrition and the disasters that complicate PEW, nephrologists can use supplementation products. In our observational, prospective, multicentre study, we administered an intradialytic parenteral nutrition of a three-compartment emulsion for intravenous infusion through an infusion pump connected to the venous line. After 12 weeks of treatment, subjects with severe malnutrition were reduced from 61.1% to 33.3%, serum creatinine increased by 16% (from 6.00 ± 1.48 mg/dL to 6.98 ± 2.46 mg/dL; P < 0.001), total protein and albumin levels respectively by 13% (from 5.46 ± 0.63 g/dL to 6.19 ± 0.66 g/dL; P < 0.001) and 19% (from 2.70 ± 0.48 g/dL to 3.20 ± 0.57 g/dL; P < 0.001), body weight by 3% (from 55.7 ± 13.2 kg to 57.6 ± 13.0 kg; P < 0.001).

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