IDPN Parenteral Nutrition

Intradilytic Parenteral Nutrition (IDPN) is a valuable source of protein and calories for chronic hemodialysis patients, who despite aggressive oral supplementation, still develop decreased albumin levels, weight loss and muscle loss.

Malnutrition is of great concern in dialysis patients because of its association with morbidity, increased hospitalization and mortality. Studies have documented that 20-60% of chronic hemodialysis patients are malnourished. Low serum albumin levels are one of the strongest predictors of survival in both peritoneal and hemodialysis patients. Improving nutritional in this population typically has been difficult or unsuccessful. Even after correcting anemia and inadequate dialysis, many patients remained malnourished. Studies have suggested the benefit of IDPN in patients on dialysis and patients with albumin levels <3.4 have benefited from the addition of IDPN.

Services:

  • Our clinical team of pharmacists, dietitians and nurses can derive individual formulation to meet each patient's nutritional needs.

  • Direct delivery to dialysis units in an efficient and timely manner.

  • IV pumps, poles and tubing for administration.

  • Refrigerator for proper storage of IDPN provided upon request.

  • 24 hour on-call services.

Benefits:

  • Improvement in patient's appetite, strength and overall well-being.

  • Replace nutrients lost during the dialysis process.

  • Increase dry body weight.

  • Increase in serum albumin levels.

  • Decrease in hospitalization rates.

  • Improvement in wound healing.

Criteria for Initiating IDPN:
(Attempt oral supplementation prior to iniiating IV nutritional support)

  • Albumin levels less than or equal to 3.4 gm/dL or
  • Prealbumin levels < 15 mg/dL or
  • Serum creatinine <8mg/dL or
  • Weight loss of >10% of IBW or >20% of usual body weight or
  • Dietary history of decreased intake of protein <0.8gm/kg/day or cloric intake of <25kcal/kg/day or
  • Clinical exam consistent with moderate to severe malnutrition.

Coverage Information:

Medicaid patients whose benefits include medication coverage and oral supplement coverage automatically qualify for coverage of IDPN therapy. Patients can be on both oral supplements and IDPN at the same time. Many private insurance companies will approve IDPN therapy with sufficient documentation of need from their clinician. Medicare patients who have permanent impairment of their gastrointestinal tract may qualify for IDPN therapy.

Carmichael's is committed to providing the highest standard of comprehensive clinical services to patients requiring infusion therapy. Our JCAHO accreditation ensures that our organization meets the highest industry standards. Our pharmacy staff has over 20 years of IV experience and is available for you and your patients on a 24-hour basis. In-services at your facility can be arranged upon request. We are locally owned and operated and are dedicated to the well-being of our community and patients.