Conventional nutritional counselling maintains nutritional status of patients on continuous ambulatory peritoneal dialysis in spite of systemic inflammation and decrease of residual renal function.
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.
Martín-Del-Campo
Fabiola
F
Unit of Medical Research in Renal Diseases, Hospital de Especialidades, CMNO, Guadalajara, Mexico.
González-Espinoza
Liliana
L
Rojas-Campos
Enrique
E
Ruiz
Norma
N
González
Juana
J
Pazarín
Leonardo
L
Cueto-Manzano
Alfonso M
AM
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