Important factors other than dialysis adequacy associated with inadequate dietary protein and energy intakes in patients receiving maintenance peritoneal dialysis.
BACKGROUND
Anorexia that results in inadequate nutrient intake is considered one of the most important causes of malnutrition in dialysis patients.


OBJECTIVE
The objective was to determine factors other than dialysis adequacy that are associated with inadequate protein and energy intakes in patients receiving continuous ambulatory peritoneal dialysis.


METHODS
Dietary protein and energy intakes were assessed with a food-frequency questionnaire in 266 patients, and factors other than dialysis adequacy that are potentially associated with reductions in energy and protein intakes were examined.


RESULTS
Only 39% of the patients had protein intakes > or = 1.2 g x kg(- 1) x d(- 1), and 26% had energy intakes > or = 126 kJ x kg(- 1) x d(- 1). Other than having a greater total urea clearance and glomerular filtration rate, patients with protein intakes > or = 1.2, as opposed to < 1.2, g x kg(- 1) x d(- 1) had lower high-sensitive C-reactive protein concentrations and fewer complications with volume overload (29% compared with 46%; P = 0.006). Patients with energy intakes > or = 126, as opposed to < 126, kJ x kg(- 1) x d(- 1) were younger, had lower high-sensitive C-reactive protein concentrations, and had a lower prevalence of diabetes (P = 0.006), atherosclerotic vascular disease (P = 0.020), and history of volume overload (P = 0.013). Multiple regression analysis showed that other than increasing age, diabetes, and total urea clearance, having a history of volume overload was independently associated with a 0.22-g x kg(- 1) x d(- 1)decrease in protein (P = 0.001) and a 13.07-kJ x kg(- 1) x d(- 1) decrease in energy intake (P = 0.006).


CONCLUSIONS
An important yet unrecognized association was observed between a history of volume overload and dietary intake in peritoneal dialysis patients.
Wang
Angela Yee-Moon
AY
Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, New Territories, China. awang@cuhk.edu.hk
Sanderson
John
J
Sea
Mandy Man-Mei
MM
Wang
Mei
M
Lam
Christopher Wai-Kei
CW
Li
Philip Kam-Tao
PK
Lui
Siu-Fai
SF
Woo
Jean
J
D000328:Adult; D000368:Aged; D000855:Anorexia / Q000209:etiology; D001161:Arteriosclerosis / Q000150:complications; D001810:Blood Volume; D002097:C-Reactive Protein / Q000032:analysis; D048909:Diabetes Complications; D003928:Diabetic Nephropathies / Q000150:complications / Q000453:epidemiology; D004044:Dietary Proteins / Q000008:administration & dosage*; D004452:Echocardiography; D002149:Energy Intake; D005260:Female; D005921:Glomerulonephritis / Q000150:complications / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D009400:Nephrosclerosis / Q000453:epidemiology / Q000209:etiology; D009748:Nutrition Disorders / Q000209:etiology*; D010531:Peritoneal Dialysis, Continuous Ambulatory; D012044:Regression Analysis; D051437:Renal Insufficiency / Q000150:complications / Q000628:therapy; D011795:Surveys and Questionnaires
D004044:Dietary Proteins; D002097:C-Reactive Protein