Abstract | BACKGROUND: AIM: To investigate the nutritional management of 23 EPS patients that underwent surgical intervention between 1999 and 2005 at Manchester Royal Infirmary, United Kingdom. METHODS: EPS was recognized by GI symptoms and diagnostically confirmed by laparotomy, computed tomographic scanning, or biopsy. RESULTS: Mean time on PD was 74 months (interquartile range 42-89 months). During the 12 months pre-diagnosis, 65% of the group showed significant weight loss (p = 0.0001), with 8 patients losing >10% of body weight; 74% of patients experienced significant albumin decrease (p = 0.001); and 56% of patients experienced GI symptoms during the 6 months pre-diagnosis. Nasogastric (NG) feeding was recommended for 8 patients but continued in only 1. 15 patients (mean albumin 27 g/L) commenced parenteral nutrition (PN); 9 patients recovered, with albumin increasing over the 6-month follow-up. Mean hospital time was 62 days for the group receiving neither NG nor PN, compared with 124.3 for the PN/NG group (p = 0.04). In patients that died of EPS, albumin continued to fall at 3 months post-diagnosis. CONCLUSION: There is currently little guidance for nutritional management of EPS. From this study we recommend (1) a high level of clinical suspicion for EPS, especially if PD patients have weight loss; (2) PN may be better than NG feeding but further studies into dual enteral nutrition and PN are needed; (3) aggressive nutritional supplementation pre- and postoperatively; and (4) dietitians need to recognize the high risk of refeeding syndrome.
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Authors | Declan de Freitas, Antoinette Jordaan, Rosalind Williams, Jane Alderdice, Janet Curwell, Helen Hurst, Alastair Hutchison, Paul E C Brenchley, Titus Augustine, Angela M Summers |
Journal | Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis
(Perit Dial Int)
2008 May-Jun
Vol. 28
Issue 3
Pg. 271-6
ISSN: 0896-8608 [Print] United States |
PMID | 18474920
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Adult
- Enteral Nutrition
- Female
- Humans
- Intubation, Gastrointestinal
- Kidney Failure, Chronic
(complications, pathology, therapy)
- Male
- Middle Aged
- Nutritional Status
- Parenteral Nutrition
- Peritoneal Dialysis
(adverse effects)
- Peritoneum
(pathology)
- Peritonitis
(etiology, pathology, therapy)
- Sclerosis
(diagnosis, pathology)
- United Kingdom
- Weight Loss
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