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NutrePletion Resources is a specialty pharmacy providing nutritional support therapies to end-stage renal disease patients. With extensive experience in providing IPN, our clinicians work closely with patients and renal care professionals in administering this complex therapy.
It is important for patients to understand the therapy they are receiving—that's why we are here to support you and to help answer any questions you may have about this therapy.
What is IPN? [top]
Intraperitoneal nutrition (IPN), also known as intraperitoneal amino acids (IPAA), is a nutrition therapy for people on peritoneal dialysis. IPN provides protein in the form of amino acids, which are rapidly absorbed. IPN is for people who cannot eat enough food or drink enough nutritional supplements in their daily diet and need extra protein calories to improve their health and well-being.
What is the purpose of IPN? [top]
While the effects on each patient are different, some may experience an improvement in dry body weight, in serum albumin levels, and in nutritional status due to the protein-building effects of the therapy.
How is IPN administered? [top]
IPN is administered at the same time as your dialysis treatment through your peritoneal dialysis (PD) exchanges, so no additional access site or needle stick is necessary. You will not taste or smell the solution.
Is IPN safe? [top]
IPN is administered under the clinical supervision of your dialysis center nurse and can be done safely at home.
Who pays for IPN treatments? [top]
If patients meet specific qualification requirements, IPN may be covered under Medicaid and certain private insurances.
Can I travel when I am on IPN therapy? [top]
IPN can be shipped to your home or any other location within the continental United States where you might be staying while traveling and administering your PD exchanges.
Will I have to increase the number of my PD exchanges to receive IPN? [top]
IPN may replace one or two of your daily PD exchanges. It will be administered at the same time as your dialysis exchanges.
Does IPN contain a large amount of potassium or phosphorus? [top]
There is no potassium or phosphorus in IPN. The solution is made of amino acids (protein), which are added to your PD solution.
Will I have to restrict my fluid intake? [top]
IPN does not affect daily fluid restriction.
What is the difference between my usual exchange/solution
compared to the IPN exchange/solution? [top]
IPN mimics your usual exchange/solution your physician has ordered, with the difference being that the amino acids (protein) replace some of the usual dextrose (sugar). Therefore, less total dextrose (sugar) is available to be absorbed.
Are there any side effects to IPN? [top]
Common side effects include nausea, vomiting, headache, fever, increased muscle cramping, dizziness, and a sense of feeling full. However, these side effects are usually minimal and can be controlled by making adjustments to the prescription or by adding medication, if necessary.
How long will I receive IPN? [top]
The length of IPN therapy varies from person to person and is dependent on your individual goals and stage of malnutrition. Your physician and dialysis unit staff will determine when these goals have been achieved.
Will I receive too much fluid from IPN? [top]
There is very low risk of fluid overload since a minimal amount of fluid is added to each bag of dialysate. The fluid will be removed during your dialysis, while the protein is absorbed.
How many times a day will I receive IPN? [top]
You will receive IPN therapy one to two times a day when you have a dialysis exchange and for the duration of your treatment until you no longer need additional nutritional support.
Do I have to change the amount of insulin I use? [top]
No. However, remember to eat before and after receiving IPN since the sugar in your typical exchange bag is replaced by amino acids (proteins) and there is a lower amount of dextrose (sugar) in the IPN exchange bag. You should only change the amount of insulin you are using based on your physician’s order.
If I am on a cycler, can I still receive IPN? [top]
IPN can be given as your daytime dwell (as long as it only dwells a maximum of 6 hours), or it can be given as a manual exchange before or immediately after your cycler exchanges.
Since IPN solutions need to be stored in a refrigerator, how long should I leave them out of the refrigerator before using them? [top]
Solutions should be removed from the refrigerator for a couple of hours prior to infusion and allowed to warm to room temperature before using. IPN bags can also be warmed on the cycler machine.
Do I need to get lab work done more often with IPN? [top]
Two weeks after you start using IPN, we recommend that you have labs drawn to make sure your dialysis prescription with IPN is right for you. After that, monthly lab work is usually enough.
1 Wolfson, Marsha and Jones,Michael. Am J of Kidney Dis. 1999 Jan, 33(2): 203-204
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