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PP312 INTRAVENOUS PAMIDRONATE IS NOT ASSOCIATED WITH RENAL DYSFUNCTION IN CHRONIC HOME PARENTERAL NUTRITION PATIENTS
Nutrition and chronic diseases II 26.43% moderate and 20.68% severe malnutrition. Active ethanol ingestion was significantly correlated with the presence of malnutrition (p = 0.03). Conclusion: Malnutrition is frequently encountered in patients with chronic pancreatitis. Due to the negative impact of malnutrition on patient’s prognosis, especially for those who necessitate surgical intervention, nutritional therapy must occupy an important place in the therapeutic management of chronic pancreatitis patients. Disclosure of Interest: None declared
PP311 DISEASE-RELATED MALNUTRITION IN OUTPATIENTS WITH SYSTEMIC SCLEROSIS R. Caccialanza1 , C. Bonino2 , C. Klersy3 , R. Caporali2 , E. Cereda1 , B. Xoxi2 , A. Crippa1 , M.L. Rava1 , M. Orlandi1 , C. Bonardi1 , B. Cameletti1 , C. Montecucco2 . 1 Servizio di Dietetica e Nutrizione Clinica, Fondazione IRCCS Policlinico San Matteo, 2 Rheumatology Division, Fondazione IRCCS Policlinico San Matteo, University of Pavia, 3 Biometry and Clinical Epidemiology Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy Rationale: To evaluate the prevalence of malnutrition in a cohort of outpatients affected by Systemic Sclerosis (SSc) and its association with disease-related clinical variables. Methods: Over a 18-month period, 160 (87.5% females) SSc patients were recruited. We evaluated the following clinical variables: organs involvement, disease duration, disease subset, disease activity and severity (European Scleroderma Study Group score and SSc Severity scale), autoantibody pattern, comorbidities, drug treatment, functional status (Health Assessment Questionnaire Disability Index: HAQ-DI) and gastrointestinal symptoms (anorexia, dysgeusia, dysphagia, nausea, vomiting, pyrosis, regurgitation, early satiation, diarrhoea and constipation). Nutritional assessment included: body mass index (BMI), weight loss history (WL), energy intake and serum prealbumin. Malnutrition was defined by BMI < 20 kg/m2 and/or 6-month previous WL 10%. Results: BMI < 20 and WL 10% were recorded in 17 (11%) and 11 (7%) patients, respectively (both criteria, n = 4). Accordingly, prevalence of malnutrition was 15% (95% CI, 10 21%). Gastro-intestinal involvement was recorded in 82 patients (51%; 95% CI, 43 59%). Simple statistical models revealed a significant association with malnutrition for disease activity (p < 0.001), anorexia (p = 0.043), early satiation (p = 0.032) and serum prealbumin (p < 0.001). No correlation was found with energy intake. Sex and age-adjusted multivariable analysis confirmed disease activity (OR = 3.5 [95% CI, 1.8 6.9], p < 0.001) and serum prealbumin (OR = 7.4 [95% CI, 2.1 25.9], p = 0.002) as independent correlates of malnutrition. Conclusion: In SSc outpatients, despite the high frequency of gastrointestinal involvement, malnutrition may appear an uncommon finding, mostly dependent on the disease activity. Serum prealbumin seems a useful parameter in the nutritional assessment of such patients. Disclosure of Interest: None declared
145 PP312 INTRAVENOUS PAMIDRONATE IS NOT ASSOCIATED WITH RENAL DYSFUNCTION IN CHRONIC HOME PARENTERAL NUTRITION PATIENTS J. Siepler1 , R. Nishikawa1 , T. Diamantidis1 , R. Okamoto1 . 1 Pharmacy, Nutrishare, INC, Elk Grove, United States Rationale: Intravenous pamidronate (IVP) is used for bone mineral disease in home parenteral nutrition patients (HPN). but, IVP has been associated with the renal dysfunction (RD). We wanted to determine if RD was more frequent in a population of HPN patients receiving IVP compared to an age and gender matched control group Methods: The records of patients from a home care provider on HPN and IVP were reviewed. We collected BUN and creatinine (BUN/Cr) for each patient receiving IVP as well as an age and gender matched control group. Primary outcome was the number of patients in each group that had a sustained (3 consecutive) two fold increase of BUN/CR over baseline. In addition, IVP dose, and time to increase of BUN/CR were collected. These data were compared to the control group. Statistics were done using chi squared with p < 0.05 being considered significant. Results: Twenty-seven patients received IVP. Four (14.8%) in the IVP group and 0 in the control group had an increase in BUN/CR (p = 0.018). Mean time to increase in BUN/CR was 3±1 years. All patients’ BUN/CR returned to normal after 2 months while remaining on IVP. There was no difference in the IVP dose compared to those who had an increase in BUN/CR and those who did not. When the 4 patients with increased BUN/CR were reviewed, it appeared the RD was likely due to dehydration. Conclusion: We report IVP use in HPN patients was associated with increase in BUN/CR compared to an age/gender matched control group. It was likely that the patients increase in BUN/CR was due to dehydration. While the patients in the control group also were at risk for dehydration, none of them had a sustained increase in BUN/CR. All patients on IVP who develop RD should be evaluated for dehydration before deciding IVP is the cause. This should be investigated further. Disclosure of Interest: None declared
PP313 THE VALUE OF LONG TERM ENTERAL NUTRITION IN THE TREATMENT OF PANCREATIC FISTULAS A PROSPECTIVE, RANDOMIZED, CONTROLLED CLINICAL TRIAL S. Klek1 , P. Szybinski1 , K. Szczepanek1 , T. Gach1 , M. Sierzega1 . 1 Home Artificial Nutrition, Nutrimed Medical Corporation, Krakow, Poland Rationale: Postoperative pancreatic fistula is the most common and potentially life-threatening complication after pancreatic surgery. Although nutritional support is a key component of conservative therapy in such cases, there are no well-designed clinical trials substantiating the superiority of either total parenteral nutrition (TPN) or enteral nutrition (EN). This study was conducted to compare the efficacy and safety of both routes of
PP311 DISEASE-RELATED MALNUTRITION IN OUTPATIENTS WITH SYSTEMIC SCLEROSIS R. Caccialanza1 , C. Bonino2 , C. Klersy3 , R. Caporali2 , E. Cereda1 , B. Xoxi2 , A. Crippa1 , M.L. Rava1 , M. Orlandi1 , C. Bonardi1 , B. Cameletti1 , C. Montecucco2 . 1 Servizio di Dietetica e Nutrizione Clinica, Fondazione IRCCS Policlinico San Matteo, 2 Rheumatology Division, Fondazione IRCCS Policlinico San Matteo, University of Pavia, 3 Biometry and Clinical Epidemiology Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy Rationale: To evaluate the prevalence of malnutrition in a cohort of outpatients affected by Systemic Sclerosis (SSc) and its association with disease-related clinical variables. Methods: Over a 18-month period, 160 (87.5% females) SSc patients were recruited. We evaluated the following clinical variables: organs involvement, disease duration, disease subset, disease activity and severity (European Scleroderma Study Group score and SSc Severity scale), autoantibody pattern, comorbidities, drug treatment, functional status (Health Assessment Questionnaire Disability Index: HAQ-DI) and gastrointestinal symptoms (anorexia, dysgeusia, dysphagia, nausea, vomiting, pyrosis, regurgitation, early satiation, diarrhoea and constipation). Nutritional assessment included: body mass index (BMI), weight loss history (WL), energy intake and serum prealbumin. Malnutrition was defined by BMI < 20 kg/m2 and/or 6-month previous WL 10%. Results: BMI < 20 and WL 10% were recorded in 17 (11%) and 11 (7%) patients, respectively (both criteria, n = 4). Accordingly, prevalence of malnutrition was 15% (95% CI, 10 21%). Gastro-intestinal involvement was recorded in 82 patients (51%; 95% CI, 43 59%). Simple statistical models revealed a significant association with malnutrition for disease activity (p < 0.001), anorexia (p = 0.043), early satiation (p = 0.032) and serum prealbumin (p < 0.001). No correlation was found with energy intake. Sex and age-adjusted multivariable analysis confirmed disease activity (OR = 3.5 [95% CI, 1.8 6.9], p < 0.001) and serum prealbumin (OR = 7.4 [95% CI, 2.1 25.9], p = 0.002) as independent correlates of malnutrition. Conclusion: In SSc outpatients, despite the high frequency of gastrointestinal involvement, malnutrition may appear an uncommon finding, mostly dependent on the disease activity. Serum prealbumin seems a useful parameter in the nutritional assessment of such patients. Disclosure of Interest: None declared
145 PP312 INTRAVENOUS PAMIDRONATE IS NOT ASSOCIATED WITH RENAL DYSFUNCTION IN CHRONIC HOME PARENTERAL NUTRITION PATIENTS J. Siepler1 , R. Nishikawa1 , T. Diamantidis1 , R. Okamoto1 . 1 Pharmacy, Nutrishare, INC, Elk Grove, United States Rationale: Intravenous pamidronate (IVP) is used for bone mineral disease in home parenteral nutrition patients (HPN). but, IVP has been associated with the renal dysfunction (RD). We wanted to determine if RD was more frequent in a population of HPN patients receiving IVP compared to an age and gender matched control group Methods: The records of patients from a home care provider on HPN and IVP were reviewed. We collected BUN and creatinine (BUN/Cr) for each patient receiving IVP as well as an age and gender matched control group. Primary outcome was the number of patients in each group that had a sustained (3 consecutive) two fold increase of BUN/CR over baseline. In addition, IVP dose, and time to increase of BUN/CR were collected. These data were compared to the control group. Statistics were done using chi squared with p < 0.05 being considered significant. Results: Twenty-seven patients received IVP. Four (14.8%) in the IVP group and 0 in the control group had an increase in BUN/CR (p = 0.018). Mean time to increase in BUN/CR was 3±1 years. All patients’ BUN/CR returned to normal after 2 months while remaining on IVP. There was no difference in the IVP dose compared to those who had an increase in BUN/CR and those who did not. When the 4 patients with increased BUN/CR were reviewed, it appeared the RD was likely due to dehydration. Conclusion: We report IVP use in HPN patients was associated with increase in BUN/CR compared to an age/gender matched control group. It was likely that the patients increase in BUN/CR was due to dehydration. While the patients in the control group also were at risk for dehydration, none of them had a sustained increase in BUN/CR. All patients on IVP who develop RD should be evaluated for dehydration before deciding IVP is the cause. This should be investigated further. Disclosure of Interest: None declared
PP313 THE VALUE OF LONG TERM ENTERAL NUTRITION IN THE TREATMENT OF PANCREATIC FISTULAS A PROSPECTIVE, RANDOMIZED, CONTROLLED CLINICAL TRIAL S. Klek1 , P. Szybinski1 , K. Szczepanek1 , T. Gach1 , M. Sierzega1 . 1 Home Artificial Nutrition, Nutrimed Medical Corporation, Krakow, Poland Rationale: Postoperative pancreatic fistula is the most common and potentially life-threatening complication after pancreatic surgery. Although nutritional support is a key component of conservative therapy in such cases, there are no well-designed clinical trials substantiating the superiority of either total parenteral nutrition (TPN) or enteral nutrition (EN). This study was conducted to compare the efficacy and safety of both routes of