Ernährungstherapie bei Dialysepflicht

ZUSAMMENFASSUNG

Bislang konnte nicht nachgewiesen werden, dass intradialytische parenterale Ernährung (IDPE) im Vergleich zu einer Ernährungsberatung und einer oralen Nahrungsergänzung bei terminaler Niereninsuffizienz die Patientengesundheit oder klinisch wichtige Ernährungsergebnisse verbessert. Aufgrund der Verbesserung von Ernährungsindikatoren empfehlen jedoch die bestehenden Leitlinien die IDPE als sinnvolle weitere Behandlungsoption für Patienten, die auf eine Ernährungsberatung und eine orale Nahrungsergänzung nicht ansprechen oder diese Erstbehandlungen aufgrund einer Fehlfunktion des Magen-Darm-Trakts oder anderer Probleme nicht erhalten können. Trotz der höheren Kosten ist somit ein Einsatz der IDPE gerechtfertigt. Zu den Nebenwirkungen der IDPE liegen nur begrenzt Daten vor. Es scheint jedoch keine signifikanten Unterschiede bezüglich unerwünschter Wirkungen zwischen Therapie- und Kontrollgruppe zu geben. In der klinischen Praxis sollte die IDPE immer auch gegen die anderen Ernährungsoptionen abgewogen und individuell über einen idealerweise initial zu definierenden und klar limitierten Zeitraum verordnet werden.

Publication History

Article published online:
18 December 2023

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