{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T12:11:07Z","timestamp":1760962267697,"version":"build-2065373602"},"reference-count":51,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2005,10,1]],"date-time":"2005-10-01T00:00:00Z","timestamp":1128124800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nut in Clin Prac"],"published-print":{"date-parts":[[2005,10]]},"abstract":"<jats:p>There is a high prevalence of protein\u2010energy malnutrition (PEM) in chronic dialysis patients. Causes of PEM include the catabolic effects of hemodialysis treatments, acidemia associated with end\u2010stage renal disease, common comorbid conditions, and uremia\u2010induced anorexia. Morbidity and mortality increase with PEM. Before considering parenteral nutrition (PN) as a nutrition intervention in a maintenance dialysis patient, all other efforts to promote optimal nutrition need to be exhausted. The first step is careful evaluation of protein\u2010energy status, followed by intensive nutrition counseling. If necessary, this is followed by oral nutrition supplementation, appetite stimulation, enteral tube feedings, and finally PN.<\/jats:p><jats:p>Short\u2010term parenteral nutrition (PN) became a crucial component of the management of a 38\u2010year\u2010old hemodialysis (HD) patient who endured serious complications after kidney transplant rejection. A profound and prolonged malnourished state followed her treatment for necrotizing pancreatitis. She had developed persistent hypercalcemia believed secondary to tertiary hyperparathyroidism (HPT) and immobilization. Later, she developed hungry bone syndrome (HBS) after parathyroidectomy (PTX). She also developed refeeding syndrome after initiation of PN. The patient's persistent, poorly understood hypercalcemia did not resolve even after PTX and removal of all other sources of vitamin D and calcium from her feedings, medications, and dialysis bath. The close communication of the inpatient and outpatient dialysis multidisciplinary teams became a key component to the successful outcome in this complex patient.<\/jats:p>","DOI":"10.1177\/0115426505020005559","type":"journal-article","created":{"date-parts":[[2008,5,14]],"date-time":"2008-05-14T19:23:41Z","timestamp":1210793021000},"page":"559-568","source":"Crossref","is-referenced-by-count":4,"title":["The Use of Parenteral Nutrition in a Severely Malnourished Hemodialysis Patient With Hypercalcemia"],"prefix":"10.1002","volume":"20","author":[{"given":"Heather","family":"Ohlrich","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathy","family":"Barco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcia R.","family":"Silver","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2005,10]]},"reference":[{"key":"e_1_2_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(99)70280-5"},{"key":"e_1_2_4_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/65.5.1544"},{"key":"e_1_2_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(12)70364-5"},{"key":"e_1_2_4_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-94-011-0806-5_13"},{"key":"e_1_2_4_6_2","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.1998.v31.pm9631845"},{"key":"e_1_2_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(96)90398-4"},{"key":"e_1_2_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1051-2276(99)90047-X"},{"issue":"2","key":"e_1_2_4_9_2","first-page":"S17","article-title":"Clinical practice guidelines for nutrition in chronic renalfailure","volume":"35","author":"National Kidney Foundation Kidney Disease Outcome Quality Initiative","year":"2000","journal-title":"Am J Kidney Dis."},{"key":"e_1_2_4_10_2","first-page":"16\u20101","volume-title":"The A.S.P.E.N. 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