Intradialytic parenteral nutrition: theory and practical application

Protein energy wasting is common in chronic kidney disease at the dialysis stage. It has an impact on morbidity and mortality, and must be diagnosed and treated as early as possible. Various strategies can be envisaged, including dietary counseling, prescription of Oral Nutritional Supplements or artificial nutrition (enteral or parenteral nutrition). Intradialytic parenteral nutrition (IDPN) involves administering parenteral nutrition during hemodialysis sessions to support a moderate food intake deficit. In this article, a group of nephrologists, dieticians and nutrition physician the indications, non-indications, administration and monitoring of IDPN. In particular, they analyze IDPN infusion rates in relation to the maximum metabolic capacities of the various nutrients.