McCusker FX, Teehan BT, Keshaviah PR, Thorpe KE, Churchill DN
Linkage between adequacy of dialysis and nutrition in CAPD
patients
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Nov) 6:609 1995
This abstract again uses the CANUSA database, although only 78
of the 680 CANUSA patients are studied. Dialytic dose and a number of
"nutritional" indices including serum albumin, PCR, subjective global
assessment [SGA] and lean body mass are followed at 6-monthly
intervals for two years. Over the two years, dialytic dose falls due
entirely to loss of residual renal function. PCR and nPCR tend to fall
slightly, but serum albumin, SGA and LBM all rise slightly. The authors
show some correlations between dialytic dose and changes in the
nutritional indices. They confirm previous observations that changes in
KT/V and creatinine clearance are positively correlated with changes in
PCR and nPCR. They show that there is also a positive correlation
between changes in KT/V and changes in serum albumin; this is not the
case for changes in creatinine clearance. Weak correlations between
changes in dialytic dose and changes in SGA are shown.
A criticism would be that it is not clear whether the nutritional
changes are really related to KT/V or to time on PD. It is clear in this
study that KT/V and time on PD are closely correlated. It should also be
pointed out that changes in KT/V in this study are totally due to change in
residual renal function and so the findings may further confirm the
importance of residual function in PD patients.
(Blake)
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Am Soc Nephrol
CRF by organ system :
Nutrition
Basic peritoneal dialysis :
Chronic PD regimens, adequacy, modeling