Nutritional Assessment of Continuous Ambulatory Peritoneal Dialysis Patients: An International Study

Young, Gerald A.; Kopple, Joel D.; Lindholm, Bengt; Vonesh, Edward F.; Vecchi, A. De; Scalamogna, Antonio; Castelnova, Claudia; Oreopoulos, Dimitrios G.; Anderson, G. Harvey; Bergström, Jonas; Dichiro, Janet; Gentile, Dominic; Nissenson, Allen R.; Sakhrani, L. M.; Brownjohn, A. M.; Nolph, Karl D.; Prowant, Barbara F.; Algrim, Corrine; Martis, Leo; Serkes, Kenneth D.

doi:10.1016/s0272-6386(12)80642-1

Cited by 474 publications

(218 citation statements)

References 13 publications

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“…Malnutrition of patients with renal failure undergoing PD has been widely reported, [1,2] and this malnutrition appears to be induced by nutritional and metabolic issues in addition to poor appetite. [1][2][3] There are many factors responsible for this malnutrition, and thus using an experimental animal model for nutritional pathophysiological research is effective.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] There are many factors responsible for this malnutrition, and thus using an experimental animal model for nutritional pathophysiological research is effective. To date, several researchers have reported PD animal models [6,7] ; however, there have been few studies that have tried to clarify the effect of nutritional supply on these models, as most of these models were developed for dialysis assessment.…”

Section: Discussionmentioning

confidence: 99%

“…However, malnutrition occurs with a high frequency in uremic patients receiving PD. [1,2] Lindholm and Bergstrom reported that PD in patients with chronic renal failure is associated with metabolic and nutritional abnormalities due to the combined influences of uremia; underdialysis; glucose absorption from the dialysate, protein, and amino acid losses; poor appetite; and recurrent episodes of peritonitis. [3] Nolph et al reported that protein loss in the continuous ambulatory peritoneal dialysis (CAPD) dialysate may be up to 15 g/day, and patients are required to ingest high-protein diets.…”

Section: Introductionmentioning

confidence: 99%

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New Peritoneal Dialysis Model in Rats with Bilateral Nephrectomy

et al. 2009

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Many peritoneal dialysis (PD) patients with chronic renal failure (CRF) suffer from metabolic and nutritional abnormalities. However, these abnormalities have been not sufficiently investigated. At present, the resolution of these issues in this field has been hindered by the lack of suitable PD models. We attempt to develop a rat model of PD under no constraints and under nonanesthetization to evaluate amino acid solution as suitable nutritional therapy for renal failure. In our model, bilateral nephrectomy rats were dialyzed 6 h per day for three days. The dialysate was infused and removed continually via a metering pump. Under fasting, rats were infused with 5% glucose or amino acid solution for renal failure, and they remained alive. This model can be used to examine bilateral nephrectomy in rats for three or more days. We were also able to determine protein and calorie malnutrition, negative nitrogen balance, abnormalities in the plasma amino acid pattern, and calcium and phosphorus metabolism. Thus, this model has the characteristics of renal failure in humans and may be used to easily examine the metabolic changes due to loss of kidney function.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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New Peritoneal Dialysis Model in Rats with Bilateral Nephrectomy

et al. 2009

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“…However, the risk of protein malnutrition, and the constraints inherent to this supplementation led to recommend a moderate dietary protein supply of about 0.8 g/kg/day (Klahr et al, 1994 ;Tom et al, 1995 ;Levey et al, 1996a;Dumler, 2011;Fouque et al, 2011a). In dialysis patients, the protein restriction question is more complex because there is a aggravated risk of protein-caloric undernutrition with an increased morbidity and mortality (30% of the dialysis patients) (Parker et al, 1983;Young et al, 1991). This leads to a rejection of protein restriction with, as a result, a proposed supply in the 1 to 1.2 g/kg/day range (Bergström, 1995 ;Cianciaruso et al, 1995 ;Qureshi et al, 1998 ;Antunes et al, 2010).…”

Section: Present Dietary Approach To Treat the Patient With Chronic Rmentioning

confidence: 99%

Role of Fermentable Carbohydrate Supplements in the Course of Uremia

Younes¹

2012

Chronic Kidney Disease and Renal Transplantation

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“…Bioimpedance analysis (BIA) has been recognized as a powerful tool to assess nutrition and hydration status in patients on CAPD [1][2][3][4] with standardized methodology [5,6] and various resistive indexes have been described [7][8][9]. We have recently shown that normalized capaci tive indices (e.g., Capacitance/Body Mass Index and Capacity × Height 2 ) carried more predictive value than non-normalized parameter like the phase angle [10].…”

Section: Introductionmentioning

confidence: 99%

Ratio of Capacitance/BMI Reflects Deficit in Nutritional Concentration While CH2 Reflects Total Nutritional Deficit in CAPD Patients and General Population

Koh¹,

Wong²

2013

OJNeph

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Traditionally phase angle was the best predictor in BIA for nutrition and survival in dialysis population. We recently showed that normalized bioimpedance indices are a better risk discriminator for dialysis patients and the general population. We hereby aimed to explore discriminating factors behind them. Methods: We assessed the body capacitive index (BCI = Capacitance × Height ) which represents total body capacitive volume in physics. We initially performed BIA for 206 female, 116 male healthy volunteers, followed by, prospective study for 128 CAPD patients (47 diabetes mellitus (DM), 81 non-DM; 59 male, 69 female) for >2 years. Results: Moderately good negative correlation of albumin and BCI (r = −0.533, p < 0.001) with linear regression (BCI = 8.780 − 0.184 × [albumin], R 2 = 0.339, p < 0.001) was shown in CAPD patients. BCI and CH 2 were much higher in CAPD patients in comparison to healthy volunteers (3.4 ± 0.1 vs 2.0 ± 0.0 nFm 2 /kg, p < 0.001 and 203 ± 8 vs 125 ± 1 nFm 2 , p < 0.001, respectively). In age and gender adjusted logistic regression model of 128 CAPD patients versus 322 healthy volunteers, the best risk discriminator was BCI (X 2 = 165.6), followed by CH 2 (X 2 = 140), phase angle (X 2 = 59.3) and BRI (X 2 = 52.2). Thirty five (27.3%) patients died during the study period (Fatal cause: infection (54%), cardiovascular (26%)). In Cox regression, CH 2 ( 2 4 X = 32.4) was the best predictor for all-cause mortality, followed by BCI ( 2 4 X = 27.7) and phase angle ( 2 4 X = 19.3). Conclusion: The phase angle was a compound parameter of the body capacity index (BCI) and body resistive index (BRI). BCI has a moderately good negative correlation with albumin and this supports its role in reflecting the severity of malnutrition in CAPD patients. CH 2 represents total nutrition deficit and thus the major risk indicator for the survival of CAPD patients.

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Nutritional Assessment of Continuous Ambulatory Peritoneal Dialysis Patients: An International Study

Cited by 474 publications

References 13 publications

New Peritoneal Dialysis Model in Rats with Bilateral Nephrectomy

New Peritoneal Dialysis Model in Rats with Bilateral Nephrectomy

Role of Fermentable Carbohydrate Supplements in the Course of Uremia

Ratio of Capacitance/BMI Reflects Deficit in Nutritional Concentration While CH2 Reflects Total Nutritional Deficit in CAPD Patients and General Population

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