Clinical Research Directory

Inclusion Criteria: 1. Age ≥ 18 years. 2. Outpatients undergoing maintenance hemodialysis at Bangli Medika Canti Hospital who are clinically stable and are not experiencing any acute condition. 3. Confirmed malnutrition, defined as a condition resulting from insufficient or imbalanced intake of energy, protein, and/or other nutrients, which may adversely affect body composition, physical and mental function, and clinical outcomes, and meeting all of the following criteria within 1-7 days: * Body Mass Index (BMI) less than 18.5 kg/m2 * Mid-upper arm circumference (MUAC) less than 24.5 cm * Serum pre-albumin level less than 16 mg/dL 4. Confirmed anemia, defined as a hemoglobin (Hb) concentration below the normal reference range within 1-7 days, specifically an Hb level of less than 13.0 g/dL in male patients or less than 12.0 g/dL in female patients. 5. At least 3 months of maintenance haemodialysis with duration of 3-4 hours per session, 2-3 times per week. 6. Provision of written informed consent prior to enrollment in this study (patient is available, can be contacted and approached). Exclusion Criteria: 1. Patients who are hospitalized at the time of data collection or who require hospitalization during the observation period. 2. History of acute bleeding at the time of admission or requiring blood transfusion. 3. Patients with clinically evident edema or fluid overload. 4. Patients receiving other enteral or parenteral nutritional support concomitantly during observation period. 5. Patients who had received IDPN before observation period 6. Patients who have received IDPN in other dialysis clinic/facilities before transferring to Bangli Medika Canti Hospital will be excluded from the study. 7. Patients for whom the data required to evaluate the primary endpoint are unavailable. 8. Patients with duplicate enrollment in the same study protocol. 9. Patients who receive albumin administration during study period.