IDPN & IPN Therapy

Nutrition Solutions to Improve Therapy for Dialysis Patients

Protein Energy Wasting (PEW): Factors in Chronic Kidney Disease (CKD)
01
Interpreting Serum Albumin
02
Albumin: Mortality, Hospitalization and Re-Hospitalization
03
Addressing and Treating PEW
04

The Proplete family of IDPN and IPN Therapy

Every patient has distinctive nutritional needs and intradialytic parenteral nutrition (IDPN) is unique as each formula is based on specific needs of the individual patient. IDPN is covered by most commercial insurance plans and is not part of a bundled payment.

Our experts strive to determine the optimal treatment dose so that protein malnourished patients receive the customized formulation best suited to meet the individual patient needs.

Download our algorithm for CKD 5 patients

We have been using your IDPN products at Pentec Health for the last 2 years and have been completely satisfied with the product and the customer service. You have been extremely helpful and professional in accomplishing our standards of service excellence to our patients in our facility.

Nancy T. Facility Administrator
Large Dialysis Organization

Proplete IDPN Formulas

Pentec Health provides uniquely tailored, patient specific IDPN formulations designed to replenish protein losses while minimizing fluid and dextrose content.

  • Protein Provision

    Ample protein is provided in weight based formulations to optimize protein repletion critical to improving nutrition status.

  • Minimized Volume Formulations

    Final formula volume is minimized by using highly concentrated base solutions for Amino Acids.

    Pentec Health’s contracts and relationships with manufacturers help to ensure provision of therapy during times of national shortage.

  • Low Dextrose Provision
    • IDPN formulas are designed to provide enough dextrose to allow amino acids to be used for protein synthesis) while limiting the dextrose infusion rate to lower the risk of increased blood glucose levels.
    • Dietitians and pharmacists review each formula to ensure glucose utilization rates are not exceeded.

Proplete IPN for PD Patients

Pentec Health provides Intraperitoneal Parenteral Therapy (IPN) therapy for the peritoneal dialysis patient. The formulas are designed to replenish protein losses seen during peritoneal dialysis, along with dextrose reduction and providing dialysis.

  • Addition of IPN to a dialysis prescription is 1-2-3 Easy!
    1. Pentec Health compounds each IPN bag by adding the prescribed amount of amino acids into the dialysate bags made by Baxter/Fresenius. The bag is then shipped to the patient’s home to replace one of their regular bags.
    2. No separate hook up is typically required by the patient so there is no risk of contamination.
    3. There is usually no special training needed, the bag is administered in the same way as the regular dialysis bag.
  • Added benefits from the addition of IPN therapy
    1. Improvement with fluid overload, when needed.
    2. Patients receive less dextrose overall.
    3. IPN ready bag is delivered directly to the patient’s home
  • We support you and your patients every step of the way
    1. The IPN formula must be refrigerated, so Pentec Health provides the patient with a refrigerator to meet this need.
    2. Our expert pharmacy staff is on call 24/7/365 to address any questions or concerns.
    3. We dedicate a Clinical Case Manager to communicate with the PD nurse to discuss and help personalize the current PD prescription and IPN prescription.
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References
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  2. Ikizler TA. Nutrition support for the chronically wasted or acutely catabolic chronic kidney disease patient. Semin Nephrol. 2009; 29:75-84.
  3. Y. Kim _ M. Z. Molnar _ M. Rattanasompattikul et al. Relative contributions of inflammation and inadequate protein intake to hypoalbuminemia in patients on maintenance hemodialysis. Int Urol Nephrol. 2013 Feb;45:215-27
  4. Kaysen G, Chertow G, Adhikarla R. et al. Inflammation and dietary protein intake exert competing effects on serum albumin and creatinine in hemodialysis patients, Kidney International, Vol. 60 (2001), pp. 333–340
  5. Leon J, Albert J, Gilchrist G et al. Am J Kidney Dis. 2006;48:28-36
  6. Cano NJ, Fouque D, Roth H, Aparicio M, et al. Intradialytic parenteral nutrition does not improve survival in malnourished hemodialysis patients: a 2-year multicenter, prospective, randomized study. J Am Soc Nephrol. 2007;18:2583-91.
  7. Dalrymple LS, Mu Y, Nguyen DV, Romano PS, Chertow GM, Grimes B, Kaysen GA, Johansen KL. Risk Factors for Infection-Related Hospitalization in In-Center Hemodialysis. Clin J Am Soc Nephrol. 2015;10(12):2170-2180.
  8. Flythe JE, Katsanos SL, Hu Y, Kshirsagar AV, Falk RJ, Moore CR. Predictors of 30-Day Hospital Readmission among Maintenance Hemodialysis Patients: A Hospital's Perspective. Clin J Am Soc Nephrol. 2016;11(6):1005-1014.
  9. U.S. Renal Data System, USRDS 2017 Annual Data Report: Atlas of Chronic Kidney Disease and End Stage Renal Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 2017
  10. Chiu PF. Tsai CD, Wu CL et al. Trajectories of serum albumin predict survival of peritoneal dialysis patients: a 15 year follow-up study. Medicine 2016;95:1-7
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  12. Kalantar Zadeh K, Cano N, Budde K et al. Diets and enteral supplements for improving outcomes in chronic kidney disease Nature Reviews Nephrology 2011;7:369-384
  13. Hiroshige K, Iwamoto K, Kabashima N. Prolonged use of intradialysis parenteral nutrition in elderly malnourished chronic hemodialysis patients. Nephrology Dialysis Transplantation. 1998; 13:2081-2087.
  14. Korzets A, Azoulay O, Ori Y, et al. The use of intradialytic parenteral nutrition in acutely ill haemodialyzed patients. Journal of Renal Care. 2008; 34:14-18.
  15. Dezfuli A, Scholl D, Lindenfeld S, et al. Severity of hypoalbunemia predicts response to intradialytic parenteral nutrition in hemodialysis patients. J Ren Nutr. 2009; 19:291-297.
  16. Chertow G, Lazarus JM, Lyden ME et al Laboratory surrogates of nutritional status after administration of intraperitoneal AA based solutions in ambulatory peritoneal dialysis patients. Journal of Renal Nutrition 1995;5:116-123
  17. Tjiong HL, Vanden Berg JW, Wattimena JL et al. Dialysate as food: combined amino acid and glucose dialysate improves protein anabolism in renal failure patients on automated peritoneal dialysis. J Am Soc Nephrol. 2005; 16:1486-93
  18. Pupim L, Flakoll, P, Brouilette Intradiaytic parenteral nutrition improves protein and energy homeostasis in chronic hemodialysis patients. J Clin Invest. 2002 110: 483-492
  19. Tjiong HL, Vanden Berg JW, Wattimena JL et al. Dialysate as food: combined amino acid and glucose dialysate improves protein anabolism in renal failure patients on automated peritoneal dialysis. J Am Soc Nephrol. 2005; 16 (5): 1486-93
  20. Pupim L, Flakoll P, Brouilette . Nutritional supplementation acutely increases albumin fractional synthetic rate in chronic hemodialysis patients. J Am Soc Nephrol. 2004 15: 1920-1926
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  23. [No authors listed]. K/DOQI clinical practice guidelines for nutrition in adult renal failure, National Kidney Foundation. Am J Kidney Dis. 2000; 35:S1-S140.