Intestinal failure in children receiving home parenteral nutrition: A Korean multicenter retrospective study

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Abstract Background Intestinal failure (IF) is a rare condition in which the intestine cannot maintain adequate nutrient absorption to support maintenance and/or growth. Data on pediatric home parenteral nutrition (HPN) in Korea are limited. We investigated the clinical characteristics of children with IF receiving HPN. Methods A nationwide multicenter retrospective study was conducted across 10 tertiary hospitals in Korea from April 2023 to June 2024. Patients who were receiving HPN and had initiated parenteral nutrition (PN) in a hospital at ≤18 years of age were included. Clinical characteristics, including catheter‐related bloodstream infection (CRBSI), intestinal failure‐associated liver disease (IFALD), micronutrient status, and anthropometric Z ‐scores, were analyzed at enrollment and compared with values at HPN initiation. Results A total of 51 patients (median age: 8.4 years) were enrolled. The most common etiologies were chronic intestinal pseudo‐obstruction (CIPO, 51%) and short bowel syndrome (39%). The median ages at initiation of PN and HPN were 0.8 and 2.5 years, respectively, and the median duration of PN at study enrollment was 7.7 years. Vitamin D deficiency was the most frequent micronutrient deficiency. From PN initiation to enrollment, 70.6% experienced at least one CRBSI episode (1.57/1000 catheter days), 17.6% had catheter thrombosis, and 41.2% had IFALD. Growth outcomes demonstrated persistent growth failure. A PN dependency ratio ≥75% was observed in 52.9% of patients at enrollment, indicating limited enteral autonomy. Conclusion This first nationwide Korean cohort study of pediatric IF reveals CIPO as the leading cause. Despite long‐term HPN, patients exhibited high PN dependency and persistent growth failure.