Focus of the Report: This report focuses on intradialytic parenteral nutrition (IDPN) for nutritional support in adults with end-stage renal disease (ESRD) who are undergoing hemodialysis.

Technology Description: IDPN is an intravenous infusion of essential nutrients administered during hemodialysis treatments to patients undergoing hemodialysis. The base solution of IDPN is composed of amino acids, glucose, and lipids. The concentration of components may vary, as the solution can be tailored to individual patient needs and can be purchased in premixed bags or mixed on-site from individual, previously prepared ingredients. IDPN is administered during regular dialysis sessions through an existing dialysis access catheter or site. No additional needlestick or line is necessary for administration.

Controversy: Guidelines recommend that IDPN be administered to malnourished patients undergoing hemodialysis who have failed previous routes of nutritional counseling, oral, and/or enteral therapies. However, IDPN is being requested or used before initiation of other treatment options, despite the lack of evidence demonstrating benefit over recommended treatments.

Key Questions:

  • Does IDPN improve health outcomes in patients with ESRD?

  • How does IDPN compare with other treatments for administering nutritional supplements to patients with ESRD?

  • Is IDPN safe?

  • Have definitive patient selection criteria been identified for IDPN for ESRD?

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