Nutritional management of a patient with chronic intestinal failure and hemodialysis receiving teduglutide: A case report

Nutrition. 2023 Sep:113:112137. doi: 10.1016/j.nut.2023.112137. Epub 2023 Jun 18.

Abstract

We present the case of a 35-y-old woman with short bowel syndrome secondary to extensive intestinal resection with associated chronic kidney disease who was undergoing hemodialysis. This patient required permanent supplementation with intradialytic parenteral nutrition because of a high-output end-jejunostomy. The patient was a candidate for treatment with teduglutide, a glucagon-like peptide 2 analog, intending to increase intestinal absorption. A complete nutritional assessment was performed using bioelectrical impedance vector analysis. Teduglutide treatment was successful, and after a 1-y follow-up, the patient had considerably reduced end-jejunostomy output (reduction of 6 L/d) and an improved nutritional status (9.1 kg weight gain, 1.4 kg fat-free mass gain, and a 2.2-degree increase in bioimpedance phase angle). However, we have been unable to reduce intradialytic parenteral nutrition, which the patient requires thrice weekly. No significant secondary effects have occurred because of teduglutide administration. This may be the first reported use of teduglutide in a patient with short bowel syndrome undergoing hemodialysis who was monitored using bioelectrical impedance data during follow-up.

Keywords: Bioelectrical impedance vector analysis; Intradialytic parenteral nutrition; Nutritional assessment; Short bowel syndrome; Teduglutide.

Publication types

  • Case Reports

MeSH terms

  • Chronic Disease
  • Female
  • Gastrointestinal Agents / therapeutic use
  • Humans
  • Intestinal Diseases*
  • Intestinal Failure*
  • Short Bowel Syndrome* / drug therapy
  • Short Bowel Syndrome* / therapy

Substances

  • teduglutide
  • Gastrointestinal Agents