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November 27, 2024 / Blogs

IDPN & IPN Nutrition Therapy for Dialysis Patients, What’s the Difference?

Intradialytic parenteral nutrition (IDPN) and intraperitoneal nutrition (IPN) are forms of targeted nutrition therapy designed to address the effects of long-term dialysis treatments.

While both treatments aim to provide nutrition, it is important to understand the differences in how they are administered and the benefits that they provide.

Dialysis

Before we discuss nutrition support for dialysis, we first need to understand the main types
of dialysis:

Hemodialysis

This is the most common type of dialysis and the form that most people are aware of. During hemodialysis a tube with a needle is connected to the arm, blood passes through the tube and into a dialysis machine that filters the blood of waste products salts, and excess fluid. It is then passed back into the arm via another tube.

This procedure is usually carried out 3 times per week in sessions lasting around 4 hours.

Peritoneal dialysis

Peritoneal dialysis is less commonly known, it uses the inside lining of the abdomen, also known as the peritoneum, as a filter for your blood, rather than an external machine.

The peritoneum and the kidneys are similar in that they both contain thousands of tiny blood vessels, this makes it effective as a filtering device for dialysis. An incision is made near the belly button and a catheter is inserted into the space inside the abdomen, called the peritoneal cavity. The catheter is left here permanently.

During dialysis, fluid is pumped into the peritoneal cavity through the catheter and as blood passes through the vessels lining the cavity, waste products and excess fluid are filtered from the blood into the dialysis fluid filling the cavity. The used fluid is drained into a catheter bag and replaced with fresh fluid.

This process takes 30 to 40 minutes and is repeated ~4 times per day.

In many cases patients are able to choose which form of dialysis they would prefer, there are advantages and disadvantages to both, it is important for patients requiring dialysis to determine with a healthcare professional which form of dialysis would suit their lifestyle the most.

Nutrition

Dialysis is critical for individuals who have failing or failed kidneys however, it comes with complications such as chronic nutrient loss, particularly of protein and amino acids. This can amount to a total loss of 13-20g during each dialysis session.1 Although it is possible to replenish low plasma amino acids with optimal dietary protein intake, it can be challenging for people on dialysis, especially if they don’t feel hungry.

Fortunately, IDPN and IPN therapy can alleviate many of these concerns faced by dialysis patients.

IDPN provides essential nutrients, including protein, carbohydrates, and sometimes fats. It is an option for people who use hemodialysis and struggle to maintain adequate nutrition. Administration is simple with the nutrients being infused into the blood that returns to the patient from the dialyzer.2

IPN is therapy for patients on peritoneal dialysis where protein is added to the patient’s peritoneal dialysate (the fluid that is passed through the peritoneal cavity) in place of the usual dextrose. This serves as a provision of protein that sufficiently replaces the amino acids lost through the peritoneal membrane while also reducing the elevated blood glucose levels often associated with dextrose dialysate.

Supported by Pentec Health

At Pentec we are the undisputed leader in clinical nutrition therapies and support services for IDPN and IPN patients on dialysis.

We act as trusted partners for providers and dialysis clinics, who rely on our deep understanding of the needs of people living with dialysis. Pentec pioneered the nutrition treatment paradigm shift 15 years ago that continues to benefit patients and their nursing teams to this day.

Our treatments at Pentec go beyond just IDPN and IPN, as it can be difficult to maintaining
adequate protein levels even while on one of these therapies. To help solve this, we also offer oral nutrition supplements. These are designed to support dialysis patients receiving IDPN therapy.

"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

If you, a loved one, a friend, or a patient could benefit from IDPN or IPN nutrition therapy, reach out to us at Pentec Health to learn more about how we support dialysis patients and their journey towards better health.

Discover more about IDPN/IPN therapy and its positive impacts on the lives of real patients in our patient stories here.

References

  1. Sahathevan, S, et al. “Understanding Development of Malnutrition in Hemodialysis
    Patients: A Narrative Review.” Nutrients, vol. 12, no. 10, Oct. 2020, p. 3147,
    https://doi.org/10.3390/nu12103147.
  2. Bossola, M, et al. “Interventions to Counteract Anorexia in Dialysis Patients.” Journal of Renal Nutrition, vol. 21, no. 1, Jan. 2011, pp. 16–19,
    https://doi.org/10.1053/j.jrn.2010.10.003.

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