Nutritional Management of Patients Undergoing Peritoneal Dialysis

Lindholm, Bengt; Bergström, Jonas

doi:10.1007/978-94-009-1085-0_13

Cited by 58 publications

(38 citation statements)

References 219 publications

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“…[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%

“…[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. [4] The development of amino acid solutions in the 1950s led to their use in patients with impossible or inadequate ingestion.…”

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: Introductionmentioning

confidence: 99%

New Peritoneal Dialysis Model in Rats with Bilateral Nephrectomy

et al. 2009

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“…However, in spite of the additional energy provided from the glucose absorbed from the dialysate, total energy intake has been reported to be low in many CAPD patients (2,36, 64,66,67). On the other hand, prospective studies of body composition using bioimpedance (38) and anthropometrics (40) show a tendency towards an increasing fat mass in patients on long-term CAPD, and obese patients should be recommended a low energy intake, increased physical activity, and restrictions in the use of hypertonic dialysis fluid.…”

Section: Energy Intake In Capd Patientsmentioning

confidence: 98%

Dietary Requirements in Peritoneal Dialysis

Heimbürger

Alvestrand

1997

Seminars in Dialysis

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“…Malnutrition is frequently seen in patients treated with peritoneal dialysis (PD) and associated with an increased morbidity and mortality rate [1][2][3]. The loss of proteins and amino acids into the dialysate (on average 9 g/day) could contribute to the development of malnutrition [1,4], In addition, the absorption of glucose from PD solu tions may induce a feeling of satiety, thus limiting oral intake of nutrients [4] and contributing to malnutrition.…”

Section: Introductionmentioning

confidence: 99%

“…The loss of proteins and amino acids into the dialysate (on average 9 g/day) could contribute to the development of malnutrition [1,4], In addition, the absorption of glucose from PD solu tions may induce a feeling of satiety, thus limiting oral intake of nutrients [4] and contributing to malnutrition. To overcome these problems, dialysis fluids have been developed in which glucose is replaced by essential and nonessential amino acids [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Biocompatibility of a 1.1 &percnt; Amino Acid-Containing Peritoneal Dialysis Fluid Compared to a 2.27&percnt; Glucose-Based Peritoneal Dialysis Fluid

Brulez

Dekker²,

et al. 1996

Nephron

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The biocompatibility of a 1.1% amino acid-containing peritoneal dialysis fluid (AA-PDF) was compared to that of a 2.27% glucose-based peritoneal dialysis fluid (G-PDF). Peritoneal macrophages (PMO), isolated from the peritoneal dialysis (PD) effluents of 10 chronic ambulatory PD patients, were tested for their phagocytosis capacity and peak chemiluminescence response. A subset of PMO was cultured for 24 h with and without lipopolysaccharide (LPS) to study the release of interleukin-1β (IL-lβ) and 8 (IL-8). As control, the interleukin release by blood monocytes of healthy donors was tested. The opsonic activity of the PD effluent was tested as well. Compared to PMO isolated from G-PDF, PMO from AA-PDF showed a significantly better phagocytosis capacity. There was no difference in the peak chemiluminescence response between PMO from AA-PDF and G-PDF. The release of IL-1β by unstimulated PMO isolated from the two fluids did not differ. Compared to control monocytes, however, PMO from both fluids showed a considerable spontaneous release of IL-1β. When stimulated with LPS, IL-1 β production by PMO from G-PDF exceeded that of PMO from AA-PDF (p < 0.002). The release of IL-8 by PMO from G-PDF was significantly higher in comparison with PMO from AA-PDF, both spontaneously and after stimulation with LPS (p < 0.02). The opsonic activity of undiluted and to 75% diluted effluents was significantly higher for G-PDF than for AA-PDF (p < 0.01). Thus, compared to the regularly used G-PDF, the phagocytosis capacity as measure for PMO function seems to be better preserved after in vivo exposure to AA-PDF. In addition, the higher release of IL-1β and IL-8 by PMO isolated from G-PDF suggests a stronger intra-abdominal activation of PMO, with G-PDF acting as a chemical inflammatory agent. Whether the lower opsonic activity of the AA-PDF is more important for biocompatibility than the other parameters is not clear. Therefore, it is concluded that, although macrophage function is better preserved, it is not proven that the 1.1% AA-PDF studied has an improved biocompatibility compared to 2.27% G-PDF.

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Nutritional Management of Patients Undergoing Peritoneal Dialysis

Cited by 58 publications

References 219 publications

New Peritoneal Dialysis Model in Rats with Bilateral Nephrectomy

New Peritoneal Dialysis Model in Rats with Bilateral Nephrectomy

Dietary Requirements in Peritoneal Dialysis

Biocompatibility of a 1.1 &percnt; Amino Acid-Containing Peritoneal Dialysis Fluid Compared to a 2.27&percnt; Glucose-Based Peritoneal Dialysis Fluid

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