This case study reports on the use of intradialytic parenteral nutrition (IDPN) to address severe malnutrition in a 38-year-old woman, redo double lung transplant recipient with a complex medical history including cystic fibrosis and end-stage renal disease (ESRD) on haemodialysis. Gastroparesis and severe postprandial abdominal pain limited oral/enteral nutrition input. The addition of IDPN resulted in a dry weight increase of 13.6% over a 12-month period and an improvement in the patient’s malnutrition status from severe (Patient-Generated Subjective Global Assessment (PG SGA) C24) to moderate (PG SGA B7). The patient stated she would recommend IDPN to others in a similar situation. Management of patients with coexisting cystic fibrosis and ESRD with or without haemodialysis requires patient engagement in treatment planning and a multidisciplinary team approach for clinical judgement in the absence of guidelines. As advances in medical care see more patients with these coexisting conditions, IDPN may provide an increasingly useful adjunct therapy.
- parenteral / enteral feeding
- cystic fibrosis
- nutritional support
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Contributors TM and LM specialise in renal dietetics and KV in respiratory dietetics, and all contributed to clinical care of the case. TM, KV and LM contributed equally to writing the manuscript. RA guided preparation of the manuscript, contributing to research, writing and editing.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.