title: Changes in nutritional status on follow-up of an incident cohort of continuous ambulatory peritoneal dialysis patients.
abstract: OBJECTIVE
  The prevalence of malnutrition in continuous ambulatory peritoneal dialysis (CAPD) patients in India has not been studied in much detail. We studied various nutritional indices of end-stage renal disease patients at the initiation of therapy.
  
  
  METHODS
  Two hundred and eighty-three CAPD patients (204 were male; mean +/- SD age, 50 +/- 14 years) were assessed for their nutritional status at the initiation of therapy. Nutritional status was assessed by anthropometry, dietary diary, subjective global assessment (SGA), and serum albumin. The patients were categorized into different grades of malnutrition, based on their nutritional indices: (1) normal nutritional status, (2) mild-moderate malnutrition, and (3) severe malnutrition.
  
  
  RESULTS
  Based on SGA, 71/283 (25.08%) had a normal nutritional status, 192/283 (67.84%) had mild-moderate malnutrition, and 20/283 (7.07%) had severe malnutrition. However, on categorizing patients in different grades of malnutrition based on serum albumin, 103/283 (36.4%) had a normal nutritional status, 175/283(61.84%) had mild-moderate malnutrition, and (5/283) 1.77% had severe malnutrition. Their mean calorie and protein intake was significantly lower than recommended (National Kidney Foundation Dialysis Outcome and Quality Initiative guidelines). Individual dietary counseling was performed, an individual diet chart was given to each patient, and counseling was repeated. There was a significant increase in nutrient intake and in grades of malnutrition of these patients during follow-up.
  
  
  CONCLUSIONS
  We conclude that the majority of the patients were already malnourished at the initiation of CAPD, and that nutrient intake and nutritional parameters improved during the follow-up of these patients.
authors.affiliation: Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. narayan@sgpgi.ac.in
authors.forename: Narayan
authors.initials: N
authors.lastname: Prasad
authors.forename: Amit
authors.initials: A
authors.lastname: Gupta
authors.forename: Archana
authors.initials: A
authors.lastname: Sinha
authors.forename: Raj Kumar
authors.initials: RK
authors.lastname: Sharma
authors.forename: Alok
authors.initials: A
authors.lastname: Kumar
authors.forename: Ramesh
authors.initials: R
authors.lastname: Kumar
mesh_terms: D000886:Anthropometry; D015331:Cohort Studies; D003376:Counseling; D004032:Diet / Q000592:standards*; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D044342:Malnutrition / Q000178:diet therapy / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D015596:Nutrition Assessment; D009751:Nutritional Requirements; D009752:Nutritional Status; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000379:methods; D015995:Prevalence; D012709:Serum Albumin / Q000378:metabolism
chemical_list: D004044:Dietary Proteins; D012709:Serum Albumin