What is the caloric prescription for HPN under Medicare?

• A. 50-60 calories per kg per day
• B. 5-10 calories per kg per day
• C. 10-15 calories per kg per day
• D. 20-35 calories per kg per day

Answer: (D)

Energy needs for home parenteral nutrition are set to meet the patient’s recovery needs without overfeeding. For adults, a practical target is about 20–35 kcal per kilogram per day. This range provides enough energy for healing and daily function while minimizing risks from overfeeding, such as hyperglycemia, fatty liver, or metabolic complications. Medicare guidelines for HPN align with this range, allowing adjustment within it based on weight, metabolic stress, and clinical response. Ranges much lower than this would underfeed and jeopardize nutrition status, while ranges much higher increase the risk of adverse effects.