Nutritional profile of continuous ambulatory peritoneal dialysis patients.
Undernutrition in dialysis patients contributes to their morbidity and mortality. This is a cross-sectional study of the nutritional status of 61 patients treated with continuous ambulatory peritoneal dialysis (CAPD). They were studied with emphasis on assessment of their nutritional intake, anthropometric measurements, and evaluation of biochemical parameters. The correlation between the rate of CAPD peritonitis and these measurements was also examined. The majority of the patients (63.1%) had inadequate protein intake ( < or = 1.2 g/kg/day). A comparable percentage had a low energy intake ( < or = 30 kcal/kg/day). Moderate malnutrition, as assessed by a low triceps skinfold thickness (TST) or a reduced midarm muscle circumference (MAMC) of < or = 20th percentile, was detected in 52% and 39% of the patients, respectively. Severe malnutrition (TST or MAMC < or = 10th percentile) was present in 36% of the patients. The serum insulin-like growth factor I (IGF-I) proved to be the most useful biochemical marker of malnutrition. It showed a positive correlation with TST (r = 0.325; p < 0.05). No significant correlation was observed with other short-life proteins such a transferrin or prealbumin. However, stepwise regression analysis showed the predictive value of serum IGF-I for anthropometric values to be low (adjusted R2 = 34.6%). Wasted patients did not appear to have more infections when compared to their healthier counterparts. However, a weak correlation was observed between TST and the number of peritonitis episodes.(ABSTRACT TRUNCATED AT 250 WORDS)
Jacob
V
V
Sheffield Kidney Institute, Northern General Hospital NHS Trust, UK.
Marchant
P R
PR
Wild
G
G
Brown
C B
CB
Moorhead
P J
PJ
el Nahas
A M
AM
D000886:Anthropometry; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000502:physiology*; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010538:Peritonitis / Q000378:metabolism / Q000628:therapy*; D012885:Skinfold Thickness; D011795:Surveys and Questionnaires
D007334:Insulin-Like Growth Factor I