[A protocol for the diagnosis and treatment of metabolic osteopathy in patients with home-based parenteral nutrition]. / Protocolo para el diagnóstico y tratamiento de la osteopatía metabólica en el enfermo con nutrición parenteral domiciliaria.

Patients presenting severe intestinal failure submitted to a home-based parenteral nutrition program have increased risk for bone metabolism impairments. This decrease in bone quality has a multifactorial origin and may be already present when implementing nutritional support. There is the need for having available protocols allowing early diagnosis of osteo-metabolic disease and implementing adequate therapy to prevent fractures and improving the quality of life of these patients.

[Spanish registry of Home-Based Parenteral Nutrition for the years 2004 and 2005 (NADYA-SENPE Group)]. / Registro de la nutrici6n parenteral domiciliaria en España de los años 2004 y 2005 (Grupo NADYA-SENPE).

OBJECTIVE: To report the results of the Home Parenteral Nutrition (HPN) registry of the NADYA-SENPE working group of the years 2004 and 2005. MATERIAL AND METHODS: We summarized the data of the new on-line HPN registry of the NADYA-SENPE group for the period 2004-2005. RESULTS: During the year 2004, 70 HPN-patients (23 males and 47 females) were registered from 14 hospitals. Mean age of adults was 53,7 +/- 14,87 years (m +/- SD) and 6 +/- 2,83 years for those younger than 14 years. The most frequent etiologies of the intestinal failure were neoplasia (24%) and mesenteric ischaemia (19%). Tunnelled catheters were used in 75% of the patients. The catheter-related infections were the most frequent complications, with a rate of 0,98 episodes/10(3) days. In 69% of the cases the nutritional support was maintained for more than 2 years. HPN solutions and disposables were supplied by the hospital pharmacy in 81% and 83%, respectively. Up to 54% of the patients had a normal activity level. The most frequent reasons to end HPN treatment were the transition to oral intake (41%), or exitus (28%). During the year 2005, 79 patients (33 males and 46 females) were registered from 14 hospitals. Mean age of adults was 52,39 +/- 14,21 years and 6,5 +/- 5,21 years for those younger than 14 yrs. The most frequent etiologies of the intestinal failure were neoplasia (22%), and mesenteric ischaemia (15%). Tunnelled catheters were used in 63% of the patients. The catheter-related infections were the most frequent complications, with a rate of 1,14 episodes/10(3) days. In 51% of the cases the nutritional support was maintained for more than 2 years. HPN solutions and disposables were supplied by the hospital pharmacy in 76% and 81%, respectively. Up to 50% of the patients had a normal activity level. The most frequent reasons to end HPN treatment were the transition to oral/enteral feeding (41%) and exitus (31%). CONCLUSIONS: We have observed a mild decrease in the number of HPN patients registered in the period 2004-2005, probably related to the change of the registry. The characteristics of the patients are similar to previous years. We have observed an increase in the septic catheter-related complications in the year 2005.