Dialysis & Renal Nutrition
Advanced Nutritional Support for Patients with End Stage Renal Disease (ESRD)
At Pharmko, we specialize in delivering advanced nutritional support for patients living with End Stage Renal Disease (ESRD). Our personalized nutrition therapies are carefully compounded based on each patient's unique medical needs and their provider's specific orders.
When Traditional Nutrition Interventions Are Insufficient
Many dialysis patients struggle with malnutrition despite dietary counseling and oral supplements. When patients show signs of protein-energy wasting, including low albumin levels, unintentional weight loss, and decreased appetite, specialized parenteral nutrition therapies can help restore nutritional status and improve outcomes.
These custom formulations are designed to optimize outcomes by maximizing essential nutrients while minimizing fluid volume and reducing the risk of side effects. Our cutting-edge, multi-function infusion pump allows for a wide range of therapies to be administered with ease and efficiency, clamping directly onto dialysis machines without the need for IV poles, improving both convenience and safety.
From specialty renal medications to full coordination of care, Pharmko supports patients and providers every step of the way, integrating our solutions seamlessly into the dialysis treatment journey.
Tailored Renal Therapies
Access to specialized renal medications and customized nutrition therapies.
Hassle-Free Prior Authorizations
Seamless coordination of prior authorizations and payer requirements.
Empowering Patients & Caregivers
Personalized education and support for patients and caregivers.
Delivery That Fits Your Life
Flexible delivery options aligned with treatment schedules and preferences.
Seamless RX Submission
Expert Support When You Need It
Three Specialized Therapies to Support Renal Nutrition
Forms of Nutrition
Intradialytic Parenteral Nutrition (IDPN)
Supplemental Nutrition During Hemodialysis Sessions
IDPN is a form of parenteral nutrition for renal care patients undergoing hemodialysis that is administered during regularly scheduled dialysis sessions. A solution of essential nutrients, including amino acids, dextrose and sometimes lipids, is infused into a vein through the dialysis venous line. No separate IV access is required.
Who Benefits from IDPN:
IDPN is designed for hemodialysis patients who:
Show signs of malnutrition (low albumin, weight loss)
Require additional protein supplementation
Have difficulty tolerating oral nutritional supplements
Need to manage fluid and glucose loads
How It Works:
Amino acids are added to the peritoneal dialysate solution, serving a dual purpose: providing nutritional support while also acting as the osmotic agent for fluid removal. This allows patients to receive nutrition during their regular peritoneal dialysis exchanges.
Coordination of Care:
Pharmko coordinates with your peritoneal dialysis center to ensure seamless integration of IPN therapy into your existing PD regimen, with ongoing monitoring and formula adjustments as needed.
Intraperitoneal Nutrition (IPN)
Amino Acid-Based Nutrition for Peritoneal Dialysis Patients
IPN is a form of parenteral nutrition for renal care patients undergoing peritoneal dialysis. It utilizes amino acids in place of dextrose as the osmotic gradient and provides nutrients through the peritoneum.
Who Benefits from IPN:
IPN is designed for peritoneal dialysis patients who:
Have albumin levels below 3.5 g/dL despite dietary interventions
Receive adequate dialysis (Kt/V ≥1.25)
Cannot meet nutritional needs through oral intake alone
Have tried and failed oral nutritional supplements
How It Works:
The therapy is administered 3 times per week during hemodialysis treatment, infusing approximately 800-1,200 calories per session. Our multi-function infusion pump connects directly to the dialysis machine, eliminating the need for additional IV poles and improving safety during treatment.
Clinical Support:
Pharmko's clinical pharmacists work closely with nephrologists and renal dietitians to monitor patient response, adjust formulations based on lab trends, and ensure optimal nutritional outcomes.
Total Parenteral Nutrition (TPN)
Complete IV Nutrition When Oral Intake Is Not Possible
TPN, sometimes referred to as Total Parenteral Nutrition, bypasses the gastrointestinal tract to provide the nutrients that the body needs. It is used to correct or prevent malnutrition when individuals are not able to obtain sufficient calories and nutrition through eating.
When TPN Is Needed:
TPN is considered for patients with End Stage Renal Disease (ESRD) when:
Severe gastrointestinal dysfunction prevents nutrient absorption
Extended bowel rest is medically required
Patients cannot meet more than 50% of nutritional needs orally
IDPN or IPN therapies are insufficient for nutritional restoration
Custom Compounding:
Pharmko's sterile compounding facility prepares customized TPN formulations with renal-specific electrolyte modifications and close monitoring protocols to ensure safety and efficacy for patients with End Stage Renal Disease (ESRD).
Starting Nutritional Therapy: Eligibility & Process
A Stepwise Approach to Renal Malnutrition Management
When to Consider Parenteral Nutrition:
Parenteral nutrition therapies like IDPN and IPN are typically recommended after:
1
Dietary counseling and education have been provided
2
Oral nutritional supplements have been tried but are unsuccessful or not tolerated
3
Patient continues to show signs of malnutrition (low albumin, weight loss, decreased appetite)
Clinical Indicators:
Healthcare providers typically consider IDPN/IPN therapy when patients present with:
Serum albumin consistently below 3.5 g/dL
Adequate dialysis dose (Kt/V ≥1.25 for hemodialysis)
Unintentional weight loss despite interventions
Poor oral intake that cannot be improved through dietary modifications
Simple Referral Process
1
Physician Referral
Your nephrologist or healthcare provider prescribes IDPN, IPN, or TPN with clinical justification and patient medical history.
2
Insurance Verification
Pharmko handles all prior authorization and insurance verification processes, typically completed within 5-7 business days.
3
Therapy Initiation
Solutions are delivered directly to the dialysis clinic with infusion pumps and supplies. Our team provides brief staff training as needed.
4
Ongoing Monitoring
Our clinical pharmacists review patient labs and nutritional status regularly, making formula adjustments in coordination with the care team.
Why Dialysis Centers Choose Pharmko
01
Pharmacy-Compounded, Individualized Solutions
Unlike pre-mixed commercial solutions, every Pharmko IDPN and IPN prescription is compounded in our sterile pharmacy to match each patient's specific metabolic needs, dialysis prescription, and clinical status.
02
Clinical Expertise Integrated with Pharmacy Services
Our licensed pharmacists specialize in renal nutrition and work collaboratively with nephrologists, renal dietitians, and dialysis nurses. We actively monitor patient response, review lab trends, and suggest formula modifications.
03
Advanced Infusion Technology
Pharmko provides multi-function infusion pumps that clamp directly onto dialysis machines, eliminating the need for IV poles. This improves safety, reduces clinic clutter, and simplifies IDPN administration.
04
Seamless Administrative Coordination
From prior authorizations to insurance verification to delivery logistics, Pharmko handles the administrative burden so your clinical team can focus on patient care.
Frequently Asked Questions
When should I consider referring a patient for IDPN or IPN therapy?
Consider parenteral nutrition when a patient shows persistent malnutrition (albumin <3.5 g/dL, weight loss) despite adequate dietary counseling and oral supplement trials. Patients should have adequate dialysis (Kt/V ≥1.25) and some level of spontaneous oral intake.
How long does the insurance authorization process typically take?
Most prior authorizations are completed within 5-7 business days. Pharmko handles all payer requirements and documentation, keeping you informed throughout the process.
What clinical monitoring is required during IDPN therapy?
Standard monitoring includes pre-dialysis blood pressure, blood glucose (especially in diabetic patients), and observation for any signs of intolerance. Pharmko's pharmacists review nutritional labs regularly and coordinate any necessary formula adjustments with your team.
Partner with Pharmko for Renal
Nutrition Excellence
Ready to refer a patient or learn more about our dialysis nutrition services? Our clinical team is here to help.
1 (877) 540-2003
