NUTRITIONAL ASSESSMENT OF CAPD PATIENTS

Appearance and progressive development of malnutrition significantly influence the efficacy and treatment outcome in chronic renal failure (CRF) patients receiving continuous ambulatory peritoneal dialysis (CAPD) therapy. The aim of the present investigation was estimation of incidence and risk factors of the malnutrition development in CRF patients treated with CAPD. Nutritional status was studied in 244 PD patients (97 women, 146 men; age 59.58±16.55 years) being under CAPD during 1-104 (median 30) months. Anthropometric (body mass index, dermato-fatty fold over 3-headed muscle, Subjective Global Assessment SGA, normalized protein catabolic rate nPCR) and biochemical indices (hemoglobin Hb, serum albumin SALB, serum pre-albumin Spre-ALB, serum cholesterol SChol) were used for nutritional status estimation. The overall mean body mass index was 28.18±47.11. The mean level of hemoglobin was 101.30±23.81 g/L, Scr was 857.28±336.17 umol/L, KT/V was 2.25±0.73. The overall mean SALB was 30.67±5.58 g/L, 74.2% patients on low SALB (SALB <35 g/L). The mean level of Spre-ALB was 331.63±91.43 mg/L, 35.66% patients on low Spre-ALB (Spre-ALB <300 mg/L). The mean level of PCR was 0.93±0.24 g/kg.d, 59.01% patients on low level PCR (PCR <1 g/kg.d). The mean dermato-fatty fold over 3-headed muscle was 13.42 mm. 25% patients had a SGA score of 1-4(malnutrition range). The prevalence of malnutrition was 18.03%. The main cause (44.6%) of death is infection in our study, and the majority of these patients were complicated with different level of malnutrition. In conclusion, the results indicate that malnutrition is quite common and plays an important role in mortality in CAPD patients independent of dialysis efficacy and prevention or treatment of malnutrition by suitable means is necessary to improve clinical outcomes in CAPD patients.