Changes in nutritional status on follow-up of an incident cohort of continuous ambulatory peritoneal dialysis patients.
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.
Prasad
Narayan
N
Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. narayan@sgpgi.ac.in
Gupta
Amit
A
Sinha
Archana
A
Sharma
Raj Kumar
RK
Kumar
Alok
A
Kumar
Ramesh
R
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
D004044:Dietary Proteins; D012709:Serum Albumin