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Nurwidda, Arvi Dian Prasetia
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Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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The Administration of Intradialytic Parenteral Nutrition Does Not Affect the Anemia Status of Chronic Kidney Disease Patients Undergoing Hemodialysis Hertanto, Decsa Medika; Nurwidda, Arvi Dian Prasetia; Tjempakasari, Artaria; Widodo, Widodo; Pranawa, Pranawa
Indonesian Journal of Kidney and Hypertension Vol 1 No 1 (2024): Volume 1 No. 1, April 2024
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v1i1.115

Abstract

Background: Hemodialysis (HD) patients are susceptible to malnutrition, and there is a close relationship between malnutrition and the incidence of anemia. Parenteral nutrition plays a role in treating malnutrition. Objective: This study aims to determine the effect of parenteral nutrition on anemia in HD patients. Methods: Quasi-experimental research which is part of the nutritional research tree at the Hemodialysis Unit of RSUP Dr. Soetomo Surabaya for 3 months. A total of 45 malnourished CKD patients (SGA B & C) undergoing routine HD were included in this study (n=26 received regular diet & education, n=17 received regular diet, education and intradialytic parenteral nutrition, and n=2 dropped out of school due to blood transfusion). Measurements of body mass index (BMI), hemoglobin (Hb), serum iron (SI), and total iron binding capacity (TIBC) were carried out before and 8 weeks after therapy. Between groups used the Mann-Whitney test, while pre and post used the Wilcoxon matched-pairs sign rank test. Results: The treatment group was older than the control group. There was no difference in duration of HD between groups. Intradialytic parenteral nutrition had no effect on BMI (24.71±3.939 vs 24.71±4.026; p=0.3802), Hb (9.746±1.309 vs 9.162±1.960; p= 0.3525), SI (62.33±34.74 vs. 53.78±24.89; p=0.3594), and TIBC (242.8±119.0 vs. 197.3±43, 65; p=0.4258). Conclusion: In HD patients, intradialytic parenteral nutrition for 8 weeks did not affect Hb, SI and TIBC levels. Long-term observations with larger samples are needed to confirm these findings.
Providing Intradialytic Parenteral Nutrition Therapy Does Not Improve Anthropometric Status in Hemodialysis Patients with Malnutrition Suryantoro, Satriyo Dwi; Tjempakasari, Artaria; Nurwidda, Arvi Dian Prasetia; Widodo, Widodo; Thaha, Mochammad; Mardiana, Nunuk
Indonesian Journal of Kidney and Hypertension Vol 1 No 1 (2024): Volume 1 No. 1, April 2024
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v1i1.123

Abstract

Background: Malnutrition is prevalent in hemodialysis patients and significantly impacts prognosis. It can result from reduced food intake and protein loss during hemodialysis. Nutritional status is determined through anthropometric examinations, which include upper arm circumference (UAC), body mass index (BMI), hand grip strength, bicep, and tricep fold thickness. Laboratory examinations like total cholesterol and Malnutrition Inflammation Score (MIS) or Subjective Global Assessment (SGA) are also used. Intradialytic Parenteral Nutrition (IDPN) is expected to maintain or improve the nutritional status of hemodialysis patients. Objective: This research examines the impact of parenteral nutrition therapy on the anthropometric status of malnourished hemodialysis patients. Methods: This cross-sectional study, a sub-analysis of a larger nutritional therapy study, involved 24 hemodialysis patients experiencing malnutrition based on SGA B and C criteria with 1-10 years of hemodialysis. IDPN therapy was provided, and anthropometric measurements and total cholesterol were taken at baseline and three months after nutritional therapy. Data processing used comparative statistical analysis. Results: The mean age was 45.33 years, with 14 males and 10 females. After 3 months, there were no significant differences in UAC (mean difference = 0.13; p = 0.69), BMI (mean difference = 0.13; p = 0.50), hand grip strength (mean difference = -0.96; p = 0.282), biceps skinfold thickness (mean difference = 0.13; p = 0.69) and triceps (mean difference = 0.59; p = 0.134) or total cholesterol (mean difference = -1.5; p = 0.71). Conclusion: IDPN therapy for 3 months did not improve the anthropometric status of hemodialysis patients with malnutrition.
Co-Authors Artaria Tjempakasari, Artaria Hertanto, Decsa Medika MOCHAMMAD THAHA Nunuk Mardiana, Nunuk pranawa pranawa, pranawa Suryantoro, Satriyo Dwi Widodo Widodo