McGriff C, Goodman D, Ting Ko W, Mulder R et al
CQI process decreases malnutrition in peritoneal dialysis patients
17th Annual CAPD Conference
Perit Dial Int Suppl 1 (Feb) 17:S75 1997

Malnutrition remains a major issue in peritoneal dialysis. In this study, special efforts were made to achieve albumin levels > 3.5 d/dL in 85% of patients and improving the quality of life for 50% of patients within a six month time frame. A special program was developed, incorporating exercise in the PD training program (also involving physicians!), a social worker emphasizing the importance of an active life style, and a dietician with a special educational program to stimulate increased protein intake.

The authors were successful: after 6 months, 80% had a serum albumin > 79% (before 50%), and 69% of the patients utilized exercise to improve their quality of life. It is concluded that exercise increased appetite, and hence serum albumin, as well as general well-being.

Comment: The conclusions, drawn from the result of this study are to be interpreted with caution. These patients were enrolled in a special program, paying much attention to the individual patient. As we know from other ESRD trials, many factors, including hypertension and maybe even progression of renal disease are positively influenced just by frequent follow-up. Furthermore, it is questionable whether these results can be maintained in the long term. Generally, every patient should be encouraged to do physical exercise. (Johan Rosman M.D., The Hague, Netherlands)

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17th Annual CAPD Conference
CRF by organ system : Nutrition