Harty JC, Boutlin H, Venning MC, Gokal R
Dialysis adequacy and nutrition in CAPD: a prospective study
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Nov) 6:601 1995
This small study is important because it is one of the few
prospective studies done on this subject. The authors prospectively
increase dialytic dose in 42 patients and leave it unchanged in 26.
Nutritional parameters are followed up over 12 months. Patients whose
KT/V was successfully increased are compared with those in whom it
decreased. There is no difference in outcome with respect to changes
in serum albumin and lean body mass. Patients with falling KT/V gain
more body fat and have an improvement in their anthropometric indices!
There is, however, a correlation between the falling KT and falling
protein intake. Protein intake, however, falls in the patients with
increasing KT also.
The authors conclude that prospective increases in dialytic dose
do not result in clear nutritional gains. They suggest that the normalizing
factor used in clearance calculations may be partly confounding the
issue.
These findings are important and are somewhat pessimistic as to
the benefits of increasing dialytic dose in PD. Patient numbers were
small, however, and further studies are needed to confirm or refute this
controversial finding.
(Blake)
To go back use the BACK button on your browser.
Otherwise click on the desired link to this article below:
Am Soc Nephrol
CRF by organ system :
Nutrition
Basic peritoneal dialysis :
Chronic PD regimens, adequacy, modeling