title: Nutritional effects of amino acid dialysate (Nutrineal) in CAPD patients.
abstract: The use of amino acid dialysate (AAD) has been shown to improve the nutritional status of malnourished continuous ambulatory peritoneal dialysis (CAPD) patients. We report on a randomized, prospective, cross-over study evaluating the effects of a single, daily, postprandial 2-L exchange of 1.1% AAD (Nutrineal) on a nutritionally unselected group of 18 stable CAPD patients. Patients in group A (n = 10) were randomized to receive AAD in the initial six months, whereas group B (n = 8) patients received AAD in the final six months of the study. Regular biochemical, hematological, and anthropometric measurements were made. A computerized nutrition score(1) combined anthropometry, serum albumin, and total lymphocyte count. Improved nutritional status was indicated by a decreased score. Mean serum albumin and transferrin did not show a significant rise in either group. However, patients in group A, with a mean serum albumin of less than 30 g/L, showed a significant rise at two months, which persisted at six months (26.8 g/L on entry, 29.0 g/L at two months, 30.1 g/L at six months; p < 0.05 and p < 0.01, respectively). Treatment with AAD showed a trend towards improvement in midarm muscle circumference in both groups (22.9 -23.5 cm, group A; 22.9-23.7 cm, group B). The nutrition score improved in both groups but was significant only in group A (14.6 to 13.1; p = 0.02). These effects of AAD on the nutritional status of CAPD patients need validation in a long-term study to evaluate the effects on morbidity and mortality.
authors.affiliation: Department of Nephrology, Charing Cross and West-minister Medical School, London, U.K.
authors.forename: M
authors.initials: M
authors.lastname: Misra
authors.forename: J
authors.initials: J
authors.lastname: Ashworth
authors.forename: D A
authors.initials: DA
authors.lastname: Reaveley
authors.forename: B
authors.initials: B
authors.lastname: Muller
authors.forename: E A
authors.initials: EA
authors.lastname: Brown
mesh_terms: D000328:Adult; D000368:Aged; D000596:Amino Acids / Q000008:administration & dosage*; D015314:Dialysis Solutions / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011502:Protein-Energy Malnutrition / Q000097:blood / Q000628:therapy*; D012709:Serum Albumin / Q000378:metabolism; D014168:Transferrin / Q000378:metabolism
chemical_list: D000596:Amino Acids; D015314:Dialysis Solutions; D012709:Serum Albumin; D014168:Transferrin