Perdialytic parenteral nutrition with lipids and amino acids in malnourished hemodialysis patients

A 3-mo perdialytic parenteral nutrition (PDPN) regimen was tested in 26 malnourished adults receiv- ing hemodialysis (HD). Subjects were randomly assigned to re- ceive PDPN (n = 12) or not to receive it (n = 14). PDPN was intravenously infused three times a week during HD; each infu- sion was made up of 1.6 g fat/kg body wt, 0.08 g N/kg body wt, essential and nonessential amino acids, and glycyl-tyrosine. PDPN, together with a PDPN-induced increase in spontaneous eating, increased intakes from 30 ± 8.4 kcal. kg body wt� .d� (i; ± SD) and 1 ± 0.27 g protein . kg body wt Id ' to 39 ± 8.5 kcal.kgbodywr'.dand 1.25 ± O.30gprotein.kgbodywr'. d�. Compared with control subjects, PDPN patients were characterized by increases in body weight (P < 0.0 1), arm-mus- dc circumference (P < 0.02), serum transthyretin and albumin concentrations (P < 0.05), interdialytic creatinine appearance (P < 0.01), skin-test reactivity (P < 0.02), plasma leucine (P < 0.05) without modifications of other amino acids, and plasma apolipoprotein A-I (P < 0.01) without significant changes in apolipoprotein B, cholesterol, triglyceride, and phospholipid concentrations. Thus, PDPN appeared to be effective and safe with respect to plasma lipids. Am J C/in Nuir 1990;52:726-30.