Nutrition, adequacy of dialysis, and clinical outcome in Indo-Asian and White European patients on peritoneal dialysis.
BACKGROUND
There is a high incidence of end-stage renal disease in Asians originating from the Indian subcontinent living in the UK. Research to date has focused on the cause of renal disease in Indo-Asians, and their outcome on peritoneal dialysis (PD) is less well studied.


OBJECTIVE
To determine whether nutrition, adequacy of dialysis, and outcome of Indo-Asian patients on PD were similar to those of White European patients.


METHODS
Prospective longitudinal observational study over 2 years.


METHODS
We enrolled 35 Indo-Asians and 35 White Europeans on peritoneal dialysis, closely matched for age, gender, diabetes and duration of renal replacement therapy. At enrolment (>3 months on PD), demographic data was recorded. From enrolment, and at 6-month intervals, dialysis adequacy, nutritional status, hospitalizations, PD infections, and treatment modality changes were recorded.


RESULTS
Dietary protein intake, which was significantly worse in Indo-Asians (particularly vegetarians), declined in all patients over time, along with other measures of nutritional status. Adequacy of dialysis, peritoneal characteristics, and PD infections were similar in Indo-Asian and White patients. Technique failure, and death rate were similar in both groups, but the transplant rate was lower in Indo-Asians.


CONCLUSIONS
Interventions are needed to improve nutritional status in these patients, particularly the Indo-Asian patients. The long-term impact of worse social deprivation and lower transplant rates in Indo-Asians needs to be investigated further.
Bakewell
A
A
Renal Services, University Hospital Coventry, Walsgrave Hospital, Coventry, UK. Anne.Bakewell@wh-tr.wmids.nhs.uk
Higgins
R
R
Edmunds
M
M
D000351:Africa, Eastern / Q000208:ethnology; D001211:Asia, Western / Q000208:ethnology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000208:ethnology / Q000628:therapy*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000502:physiology*; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D011446:Prospective Studies; D016896:Treatment Outcome