title: Conventional nutritional counselling maintains nutritional status of patients on continuous ambulatory peritoneal dialysis in spite of systemic inflammation and decrease of residual renal function.
abstract: OBJECTIVE
  To evaluate the effect of nutritional counselling on nutritional status in peritoneal dialysis patients.
  
  
  METHODS
  Twenty-nine peritoneal dialysis patients were randomly selected to receive conventional nutritional counselling during 6 months of follow up. All patients had monthly clinical and biochemical evaluations, and assessments of dialysis adequacy, inflammation and nutritional status at 0, 3 and 6 months.
  
  
  RESULTS
  Moderate-severe malnutrition decreased 28% whereas normal nutrition increased 23% at final evaluation (non-significant). Calorie and protein intake remained stable throughout the study (baseline vs final, calorie: 24 +/- 8 vs 23 +/- 5 Kcal/kg; protein: 1.1 +/- 0.5 vs 1.0 +/- 0.3 g/Kg, respectively). On the other hand, triceps (16 +/- 6 vs 18 +/- 8 mm) and subscapular (17 +/- 8 vs 20 +/- 5 mm) skinfold thicknesses, and mid-arm circumference (27 +/- 3 vs 28 +/- 3 mm) significantly increased; mid-arm muscle area displayed a non-significant trend to increase (30 +/- 9 vs 31 +/- 9 cm(2)) whereas serum albumin significantly increased at the end of study (2.67 +/- 0.46 vs 2.94 +/- 0.48 g/dL). At final evaluation, median renal creatinine clearance decreased (6.3 (0.8-15.3) vs 2.0 (0.1-6.3) L/week per 1.73 m(2)) whereas interleukin-6 increased (2.33 (1.9-7.0) vs 4.02 (2.1-8.4) pg/mL).
  
  
  CONCLUSIONS
  Even though conventional nutritional counselling, as an isolated measure, did not significantly improve all nutritional parameters, it prevented a greater deterioration during 6 months. Nutritional counselling maintained the nutritional status in spite of a decrease in residual renal function and higher systemic inflammation.
authors.affiliation: Unit of Medical Research in Renal Diseases, Hospital de Especialidades, CMNO, Guadalajara, Mexico.
authors.forename: Fabiola
authors.initials: F
authors.lastname: Martín-Del-Campo
authors.forename: Liliana
authors.initials: L
authors.lastname: González-Espinoza
authors.forename: Enrique
authors.initials: E
authors.lastname: Rojas-Campos
authors.forename: Norma
authors.initials: N
authors.lastname: Ruiz
authors.forename: Juana
authors.initials: J
authors.lastname: González
authors.forename: Leonardo
authors.initials: L
authors.lastname: Pazarín
authors.forename: Alfonso M
authors.initials: AM
authors.lastname: Cueto-Manzano
mesh_terms: D000328:Adult; D000368:Aged; D003376:Counseling; D005260:Female; D006801:Humans; D007249:Inflammation / Q000378:metabolism*; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011446:Prospective Studies