PD402 - ASSOCIATION BETWEEN AMINO ACID DOSE AND CLINICAL OUTCOMES IN HOSPITALIZED PATIENTS WITH CHRONIC KIDNEY DISEASE RECEIVING EXCLUSIVE PARENTERAL NUTRITION: A RETROSPECTIVE COHORT STUDY
PD402
ASSOCIATION BETWEEN AMINO ACID DOSE AND CLINICAL OUTCOMES IN HOSPITALIZED PATIENTS WITH CHRONIC KIDNEY DISEASE RECEIVING EXCLUSIVE PARENTERAL NUTRITION: A RETROSPECTIVE COHORT STUDY
R. Hamamoto1,*, H. Kabasawa2, H. Yoshida3, A. Shintani3, M. Tani1, S. Kamoshita1, M. Hosojima2
1Medical Affairs Department, Otsuka Pharmaceutical Factory, Inc., Tokyo, 2Aizubange Center for Nephrology and Clinical Nutrition, Fukushima Medical University, Fukushima, 3Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine Department of Clinical Medical Science, Osaka, Japan
Rationale: This study aimed to evaluate the optimal amino acid dose for hospitalized patients with chronic kidney disease (CKD) receiving exclusive parenteral nutrition.
Methods: We analyzed a Japanese administrative claims database to identify patients with CKD admitted to acute-care hospitals between 2012 and 2023 who received exclusive parenteral nutrition for ≥10 days. The mean prescribed parenteral amino acid dose (g/kg/day) was calculated from days 4–10 of parenteral nutrition. We assessed associations between amino acid dose and outcomes (in-hospital mortality, length of hospital stay, activities of daily living, and readmission) using Cox proportional hazards, logistic regression, and Fine–Gray models with multivariable adjustments. We then applied restricted cubic splines to model nonlinear associations and plotted linear predictors against prescribed amino acid doses (0.0–1.0 g/kg/day).
Results: Among 38,577 patients, 84.3% were aged ≥70 years, 35.4% were female, 29.1% had a body mass index <18.5 kg/m², and 26.2% were receiving maintenance dialysis. The mean prescribed amino acid dose during days 4–10 was 0.27 g/kg/day.No significant associations were observed for activities of daily living or readmission.
Conclusion: For hospitalized patients with CKD receiving exclusive parenteral nutrition, an amino acid dose of at least 0.3 g/kg/day may be necessary.
Disclosure of Interest: R. Hamamoto Other: employee of Otsuka Pharmaceutical Factory, Inc., H. Kabasawa: None declared, H. Yoshida: None declared, A. Shintani: None declared, M. Tani Other: employee of Otsuka Pharmaceutical Factory, Inc., S. Kamoshita Other: employee of Otsuka Pharmaceutical Factory, Inc., M. Hosojima Consultant for: advisory fees from Otsuka Pharmaceutical Factory, Inc.