Describe the impact of dialysis by high permeability and adsorbent membrane (PEPA®) associated with oral nutritional supplementation on the nutritional status of malnourished chronic end-stage renal disease patients dependent on intradialytic parenteral nutrition.

The study proposes to compare the nutritional state after 6 months of dialysis with standard membrane associated with intradialytic parenteral nutrition (retrospective phase) with the nutritional state after 6 months of dialysis with high permeability membrane associated with oral nutritional supplementation (prospective phase).

Inclusion Criteria:

• Patient with renal failure, on hemodialysis for at least 12 months;
• Hemodialysis patient in 3 weekly sessions on a device with a standard permeability membrane (polysulfone, polyethersulfone or polyartylethersulfone type);
• Malnourished patient, on intradialytic parenteral nutrition for at least 6 months;
• Patient who may benefit, according to the doctor, from a change in dialysis and nutrition strategy:
• Patient who signed an informed consent form to participate in the study

Exclusion Criteria:

• Known allergy to PEPA® ;
• Protected patient (under legal protection, or deprived of liberty by judicial or administrative decision);
• Patient with a chronic infection in progress;
• Patient with life expectancy <6 months according to the investigator;
• Inability to understand information related to the study (linguistic, psychological, cognitive reason, etc.);
• Pregnant woman or likely to be (of childbearing age, without effective contraception) or breastfeeding;
• Patient participating in another clinical trial, or in a period of exclusion from another clinical trial;
• Patient not benefiting from a social security scheme.