| 000 | 03081cam a2200205 4500500 | ||
|---|---|---|---|
| 005 | 20251214030052.0 | ||
| 041 | _afre | ||
| 042 | _adc | ||
| 100 | 1 | 0 |
_aTrolonge, Stanislas _eauthor |
| 700 | 1 | 0 |
_aBataille, Stanislas _eauthor |
| 700 | 1 | 0 |
_aPasian, Céline _eauthor |
| 700 | 1 | 0 |
_aKoppe, Laetitia _eauthor |
| 700 | 1 | 0 |
_aChauveau, Philippe _eauthor |
| 245 | 0 | 0 | _aNutritional care and use of intradialytic parenteral nutrition in hemodialysis in France: A national survey among nephrology dietitians |
| 260 | _c2025. | ||
| 500 | _a30 | ||
| 520 | _aMalnutrition remains a major concern among hemodialysis patients in France and worldwide. An online survey was disseminated by the Association de Diététique et Nutrition en Néphrologie (ADNN) between March and June 2023, targeting its dietitian members via email and professional social networks. A total of 88 responses were collected (35% of those solicited), of which 73% were from the public or non-profit sector, and 47% of professionals reported following more than 150 hemodialysis patients annually. The aim of this study was to assess the practices of dietitian-nutritionists regarding the screening, diagnosis, and treatment of malnutrition, with a particular focus on the use of intradialytic parenteral nutrition (IDPN) in France. The reported prevalence of malnutrition ranged from 20 to 75% of patients, with 60% of dietitians estimating it between 20 and 50%. Screening was performed every 1 to 3 months by 70% of respondents, mainly based on weight loss (98%), body mass index (BMI) (89%), and biological markers such as albumin and CRP (monitored monthly by 50 to 60%). Normalized protein nitrogen appearance (nPNA) was used monthly by 42% of dietitians and at least annually by 80%. Regarding IDPN, only 35% reported having a protocol, 69% initiated it in cases of severe malnutrition or significant weight loss, and 45% reported infusion volumes of between 500 and 1,000 mL per session. The mean duration of use was 3 months for 28% of respondents but could extend beyond a year depending on nutritional recovery. Overall, 81% reported insufficient knowledge, and 75% expressed a need for additional training. This survey highlights a marked heterogeneity in the choice, duration, and monitoring of IDPN, the frequent absence of standardized protocols, and substantial training needs. It also underscores the lack of dedicated time for dietitians to follow up with hemodialysis patients: More than half of the respondents reported spending less than 30% of their working time on this population, thereby compromising the effectiveness of nutritional screening and management. Better standardization of practices, increased time allocation for patient care, and enhanced competencies in artificial nutrition appear essential to optimize the nutritional management of hemodialysis patients. | ||
| 786 | 0 | _nNéphrologie & Thérapeutique | 21 | 6 | 2025-11-27 | p. 495-508 | 1769-7255 | |
| 856 | 4 | 1 | _uhttps://stm.cairn.info/journal-nephrologie-therapeutique-2025-6-page-495?lang=en&redirect-ssocas=7080 |
| 999 |
_c1573395 _d1573395 |
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