Proposed clinical trials in the evaluation of intradialytic parenteral nutrition

New revised policies relating to intradialytic parenteral nutrition (IDPN) reimbursement by Medicare have made it difficult, if not impossible, to qua lify malnourished hemodialysis patients for this potentially useful therapy . These policies were adopted by Medicare because of a lack of studies that provide clear documentation of the medical benefits of IDPN or their cost effectiveness. We propose a limited study of the role of IDPN with and with out anabolic growth factors to improve predefined nutritional parameters an d document its cost-effectiveness by monitoring hospitalization and mortali ty, The proposed study will be multicenter, prospective, limited to severel y malnourished patients, and will include a control group that would receiv e standard of care. (C) 1999 by the National Kidney Foundation, Inc.