title: Impact of peritoneal absorption of glucose on appetite, protein catabolism and survival in CAPD patients.
abstract: Dietary protein and calorie intake, protein catabolism and peritoneal kinetics were measured in 97 CAPD patients to establish the effect of peritoneal glucose absorption on appetite and survival. There was a large variability in the number of calories obtained from the dialysate, mean 5.89 cal/kg (median 5.43 cal/kg), with a skewed distribution, due to the increased requirement for hypertonic solutions by patients with more rapid glucose absorption and poor ultrafiltration. On average calories derived from peritoneal absorption accounted for 19% of the total energy intake which in itself was well below that recommended. Patients with > 6 cal/kg, obtained from the dialysate (top 20th percentile, n = 19) were compared with those with < 6 cal/kg, but no significant differences in oral protein or calorie intake, protein catabolism or total calorie intake were found. Age, body mass index (BMI) and KT/V were also similar in both groups. Patients were followed-up prospectively for a minimum of 24 months and a comparison made of actuarial survival. Patients with high peritoneal calorie intake tended to survive longer but this was not significantly different (p = 0.25). This study suggests that calories derived from the peritoneum in CAPD patients do not suppress appetite, provide a useful and significant proportion of the total energy intake, that does not cause excessive obesity or have a negative effect on patient survival.
authors.affiliation: Renal Unit, North Staffordshire Hospital, Stoke-on-Trent, United Kingdom.
authors.forename: S J
authors.initials: SJ
authors.lastname: Davies
authors.forename: L
authors.initials: L
authors.lastname: Russell
authors.forename: J
authors.initials: J
authors.lastname: Bryan
authors.forename: L
authors.initials: L
authors.lastname: Phillips
authors.forename: G I
authors.initials: GI
authors.lastname: Russell
mesh_terms: D000042:Absorption; D000293:Adolescent; D000328:Adult; D000368:Aged; D001066:Appetite / Q000502:physiology*; D001692:Biological Transport; D015992:Body Mass Index; D015314:Dialysis Solutions / Q000378:metabolism; D004044:Dietary Proteins / Q000378:metabolism; D002149:Energy Intake; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000401:mortality* / Q000628:therapy; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010537:Peritoneum / Q000378:metabolism*; D011446:Prospective Studies; D011506:Proteins / Q000378:metabolism*; D015996:Survival Rate; D014508:Urea / Q000378:metabolism
chemical_list: D015314:Dialysis Solutions; D004044:Dietary Proteins; D011506:Proteins; D014508:Urea; D005947:Glucose