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Renal function in patients with intestinal failure receiving home parenteral support
Sophie Maria Mathiesen1, Kristian Asp Fuglsang1, Giovanna Ranzato2
1Department of Gastroenterology and Hepatology, Rigshospitalet, Copenhagen, Denmark.
JPEN. Journal of Parenteral and Enteral Nutrition
|April 29, 2021
Summary
Patients with intestinal failure receiving home parenteral support experience a significant decline in kidney function, primarily in the first year. Diabetes and high support volumes are risk factors for renal impairment.
Area of Science:
- Nephrology
- Gastroenterology
- Internal Medicine
Background:
- Patients with intestinal failure (IF) on home parenteral support (HPS) may experience progressive renal impairment.
- Annual decline in estimated glomerular filtration rate (eGFR) is a known concern.
Purpose of the Study:
- To analyze eGFR changes over 5 years post-HPS initiation.
- To identify risk factors for renal function loss in IF patients on HPS.
Main Methods:
- Retrospective database study.
- Inclusion of nonmalignant IF patients discharged with HPS.
- Analysis of eGFR changes over an 8-year period.
Main Results:
- Mean eGFR decreased by 15.3 ml/min/1.73 m² in the first year of HPS.
- Subsequent eGFR decline slowed but remained significant.
- Risk factors identified: increasing age, female sex, higher body weight, diabetes, and high HPS volume.
Conclusions:
- The most substantial eGFR decline occurs within the first year of HPS in nonmalignant IF patients.
- Potential causes include dehydration and hyperaldosteronism, or increased creatinine production from muscle mass.
- Patients with diabetes and high HPS volume requirements need closer monitoring.
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