Intradialytic parenteral nutrition as a therapy for malnourished hemodialysis patients.

B.H. did not consistently meet the expected outcomes related to maintenance of fluid balance and normal blood glucose levels. Interdialytic episodes of hypotension continued intermittently despite efforts of the multidisciplinary team to frequently assess the patient, alter the treatment plan, and avoid complications. Although postdialysis rebound hypoglycemia occurred, it was infrequent. B.H. did, however, meet the expected patient outcome related to nutrition. His nutritional parameters at the end of IDPN therapy correlated with dramatic improvement in his clinical status. Three months after the termination of the IDPN therapy, he showed continued improvement on oral intake only. Ongoing support from all nephrology professionals permitted this patient to obtain and maintain a desirable weight and nutritional status that eventually led to successful renal transplantation.