Nutritional interventions found effective for hemodialysis patients, increasing energy intake

In recent years, advancements in dialysis therapy and the growing number of elderly patients starting dialysis have contributed to the aging of the overall dialysis population. Consequently, malnutrition-related conditions such as sarcopenia, frailty, and protein energy wasting (PEW) have become significant issues for dialysis patients.

Nutritional interventions, including nutritional counseling, oral supplements, and intradialytic parenteral nutrition (IDPN), are recommended to address these challenges.

On dialysis days, patients tend to consume less food, and the combination of nutrient losses during dialysis and increased energy expenditure often exacerbates malnutrition.

While IDPN has the potential to improve the nutritional status of hemodialysis patients, its methods and effectiveness are not yet well established.

To investigate this, a research group from Tokyo Medical University, Niigata University, and Otsuka Pharmaceutical Factory conducted a 12-week randomized controlled trial to evaluate the effects of IDPN using ENEFLUID (310 kcal, 550 mL) in malnourished hemodialysis patients.

The findings are published in the journal PLOS ONE.

The study included 20 patients in the IDPN group and 19 in the control group, with an average age of 72 years and an average body mass index (BMI) of 20.

The primary outcome, the change in serum transthyretin levels after 12 weeks, showed no significant difference between the two groups. However, the IDPN group demonstrated a significant increase in energy intake from food after 12 weeks. Additionally, flash glucose monitoring revealed a significant reduction in hypoglycemia during dialysis in the IDPN group. No adverse events related to ENEFLUID infusion were observed.

Although this study did not demonstrate direct improvements in nutritional markers, Dr. Hideyuki Kabasawa from Niigata University noted, "The increase in food intake and reduction in hypoglycemia during dialysis observed in the IDPN group suggests that prolonged use of IDPN may indirectly improve the nutritional status."

These findings highlight the potential benefits of IDPN and point to the need for further research to establish optimal IDPN protocols.