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Nutrition in Clinical Practice
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Parenteral Nutrition-Associated Metabolic Bone Disease: Pathophysiology, Evaluation, and Treatment

Douglas L. Seidner, MD, FACG, CNSP

Angelo Licata, MD, PhD, FACP, FACE

Parenteral nutrition (PN) is generally given to provide adequate amounts of macronutrients and micronutrients to allow recovery after injury and illness. Maintenance of the skeleton is often neglected when one prepares a PN prescription. Although this may not be critical for the brief length of time that most patients receive PN, it becomes an important consideration in patients who need long-term PN, during which time metabolic bone disease (MBD) can develop. It is therefore important to have an understanding of the factors involved in normal bone metabolism and the impact that PN has on this process. This review describes some of the important factors that may play a role in the development of parenteral nutrition-associated metabolic bone disease (PN-MBD) and discusses a strategy for the diagnosis and treatment of this problem.

Nutrition in Clinical Practice, Vol. 15, No. 4, 163-170 (2000)
DOI: 10.1177/088453360001500402
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