| Summary: | Chronic kidney disease (CKD) is a major public health concern, affecting 14.8% of US adults in 2011-2014, and was the 9th leading cause of death in the US in 2016. Progression of CKD leads to end-stage renal disease (ESRD), a total and permanent failure of kidney function requiring kidney transplant or maintenance hemodialysis. More than half (63.1%) of all prevalent ESRD cases receive hemodialysis, and despite its advantages, hemodialysis patients often suffer poor health outcomes, including substantially worse survival rates than the general population. The most recent systematic review from 2010 concluded that data at that time were insufficient to definitively determine the benefit of IDPN.47 However, since 2010, 3 new randomized controlled trials have emerged. The objective of this evidence brief is to synthesize the evidence regarding the effectiveness, harms, and cost-effectiveness of using intradialytic parenteral nutrition (IDPN) in hemodialysis patients with malnutrition
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