title: Adequacy and nutrition in the absence of residual renal function in peritoneal dialysis.
abstract: With the aim of evaluating nutrition indices and dialysis adequacy level in patients who started peritoneal dialysis (PD) without residual renal function, we retrospectively studied 19 patients [8 men, 11 women; 3 with diabetes (15.8%); mean age: 44.5 +/- 10.74 years; 15 on continuous ambulatory peritoneal dialysis (CAPD), 3 on continuous cycling peritoneal dialysis (CCPD), 1 on nightly intermittent peritoneal dialysis (NIPD)]. The mean time spent by these patients on hemodialysis before PD was 62.7 +/- 54.7 months (range: 8.8-216 months), and the mean time on PD was 46.2 +/- 21.4 months (range: 10-75 months). In these patients, we measured weekly Kt/V urea, weekly creatinine clearance (CrC), normalized protein catabolic rate (nPCR), body surface area (BSA), urea distribution volume (V), serum albumin, body mass index (BMI), percent lean body mass (%LBM), infusion volume (liters per day), subjective global assessment (SGA), and peritoneal equilibration test (PET). Using the Student t-test at a significance level of p < 0.05, we compared initial body weight (INW), actual weight (AW), and ideal body weight (IBW) according to age, sex, and height. We analyzed actuarial and technique survival (Kaplan-Meier). In regard to patient survival, only death was considered the end point; for technique survival, only technique failure was considered the end point. Data are expressed as mean +/- standard deviation. Results were: Kt/V, 2.20 +/- 0.46 L weekly; CrC, 59.11 +/- 12 L weekly; nPCR, 1.08 +/- 0.25 g/kg daily; BSA, 1.67 +/- 0.2 m2; V, 33.34 +/- 7.12; serum albumin, 3.68 +/- 0.22 g/dL; BMI, 24.06 +/- 4.16; %LBM, 64.92 +/- 10.13; SGA, 94.7% well-nourished; AW, 65.37 +/- 13.88 kg; IBW, 67.21 +/- 10.5 kg (AW vs IBW: r = 0.69, p > 0.05); INW, 61.54 +/- 11.07 kg (INW vs AW: r = 0.92, p < 0.05; INW vs IBW: r = 0.71, p < 0.05). Distribution of transport status by PET was 15.8% high transport, 36.8% high-average transport, 36.8% low-average transport, and 10.5% low transport. Mean infusion volume was 10.41 +/- 1.36 L in 24 hours. Cumulative survival was 100%, 98%, and 82% after 1, 2, and 6 years respectively. Technique survival was 100% after 6 years. The adequacy results accord with Dialysis Outcomes Quality Initiative (DOQI) recommendations, and the nutrition indices and actuarial and technique survival are satisfactory for anuric patients.
authors.affiliation: Servicio de Terapia Renal Hurlingham SRL, Centro Integral de Diálisis, Hospital Israelita, Buenos Aires, Argentina.
authors.forename: R
authors.initials: R
authors.lastname: Canale
authors.forename: R J
authors.initials: RJ
authors.lastname: Barone
authors.forename: N S
authors.initials: NS
authors.lastname: Gimenez
authors.forename: M
authors.initials: M
authors.lastname: Santopietro
authors.forename: L
authors.initials: L
authors.lastname: Ramirez
authors.forename: A
authors.initials: A
authors.lastname: Palliotti
authors.forename: P
authors.initials: P
authors.lastname: Romero
authors.forename: D
authors.initials: D
authors.lastname: Amado
mesh_terms: D000328:Adult; D001692:Biological Transport; D015992:Body Mass Index; D001835:Body Weight; D003404:Creatinine / Q000378:metabolism; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010530:Peritoneal Dialysis; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010537:Peritoneum / Q000378:metabolism; D011506:Proteins / Q000378:metabolism; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis; D014508:Urea / Q000378:metabolism
chemical_list: D011506:Proteins; D012709:Serum Albumin; D014508:Urea; D003404:Creatinine