LB060
ASSOCIATION BETWEEN LIPID PRESCRIPTION AND CLINICAL OUTCOMES IN HOSPITALIZED PATIENTS WITH CHRONIC KIDNEY DISEASE RECEIVING EXCLUSIVE PARENTERAL NUTRITION: A REAL-WORLD RETROSPECTIVE COHORT STUDY
M. Hosojima1,*, H. Kabasawa1, H. Yoshida2, A. Shintani2, R. Hamamoto3, M. Tani3, S. Kamoshita3
1Aizubange Center for Nephrology and Clinical Nutrition, Fukushima Medical University, Fukushima, 2Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, Osaka, 3Medical Affairs Department, Otsuka Pharmaceutical Factory, Tokyo, Japan
Rationale: This study aimed to evaluate the association between intravenous lipid prescriptions and clinical outcomes in hospitalized patients with chronic kidney disease (CKD) receiving exclusive parenteral nutrition.
Methods: We analyzed a Japanese administrative claims database to identify CKD patients admitted to acute-care hospitals between 2012 and 2023 who received exclusive parenteral nutrition for ≥10 days. Patients were categorized into Lipid and Non-lipid groups based on lipid prescriptions on days 4–10. One-to-one propensity score matching (PSM) was performed, and balance was assessed using standardized mean differences (SMDs). The outcomes included in-hospital mortality, length of hospital stay, decline in activities of daily living (ADL) at discharge, and 30-day readmission. Cox models were used for mortality and readmission, a Fine–Gray model for the length of hospital stay, and logistic regression for ADL decline. Effect estimates were reported as hazard ratios (HRs), sub-distribution hazard ratios (sHRs), or odds ratios with 95% confidence intervals (CIs).
Results: Of the 38,577 patients, 31,391 (81.4%) were in the Non-lipid group and 7,186 (18.6%) were in the Lipid group. After PSM, 6,454 pairs were created, with all SMDs <0.1. The mean lipid dose on days 4–10 was 0.2 g/kg/day. In-hospital mortality was 47.9% in the Non-lipid group and 40.7% in the Lipid group (HR 0.79, 95% CI 0.75–0.83, p<0.001). The sHR for length of hospital stay was 0.81 (95% CI 0.77–0.86, p<0.001). No significant differences were observed in 30-day readmission or ADL decline.
Conclusion: Parenteral lipid prescription was associated with reduced in-hospital mortality and length of hospital stay in hospitalized patients with CKD receiving exclusive parenteral nutrition.
Disclosure of Interest: M. Hosojima Consultant for: advisory fees from Otsuka Pharmaceutical Factory, Inc., H. Kabasawa: None declared, H. Yoshida: None declared, A. Shintani: None declared, R. Hamamoto Other: employee of Otsuka Pharmaceutical Factory, Inc., M. Tani Other: employee of Otsuka Pharmaceutical Factory, Inc., S. Kamoshita Other: employee of Otsuka Pharmaceutical Factory, Inc.
