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Journal of Parenteral and Enteral Nutrition
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Original Communications

Use of Parenteral Nutrition in Patients Receiving Isolated Kidney or Simultaneous Pancreas/Kidney Transplantation

Gordon S. Sacks, PharmD, FCCP, BCNSP*, Jose E. Aguilar-Nascimento, MD{dagger} and Kenneth A. Kudsk, MD{dagger}

From the * Division of Pharmacy Practice, School of Pharmacy, and the {dagger} Department of Surgery, Division of General Surgery, University of Wisconsin–Madison, Madison, Wisconsin

Correspondence: Gordon S. Sacks, PharmD, 777 Highland Avenue, University of Wisconsin–Madison, Madison, WI 53705. Electronic mail may be sent to gssacks{at}pharmacy.wisc.edu.

Background: There is little information available on the use of parenteral nutrition (PN) in patients after a kidney (KID) or simultaneous pancreas-kidney (SPK) transplantation. This study examined the indications and use of PN in these patients. Methods: Retrospective study of 25 patients (12M/13F; mean age: 51 ± 11 years old) receiving PN after KID or SPK transplantation. Patients were divided in 2 groups according to the number of PN days (group A = <7 days and group B = >7 days). Results: Overall mortality was 16% (group A: 0/7; group B: 4/18). Postoperative ileus (n = 7), intestinal fistula (n = 5), and nausea/vomiting (n = 4) were the most common indications for PN. Functional disorders accounted for 56% (14/25) of the indications for PN. Factors differentiating group A (7/25; median = 5 [4–6] days) from group B (18/25; median =9 [7–31] days) included a significantly higher preoperative serum albumin, SPK transplantation for the first time, and diagnosis of ileus as the indication for PN initiation. Conclusions: Functional disorders of the digestive tract are the primary reason for initiation of PN in isolated KID and SPK transplantation patients. Well-nourished patients undergoing their first SPK transplantation who develop postoperative ileus usually do not need nutrition intervention.

Journal of Parenteral and Enteral Nutrition, Vol. 31, No. 1, 8-11 (2007)
DOI: 10.1177/014860710703100108
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