Nutritional Problems of Asian Peritoneal Dialysis Patients

Abstract

Clear evidence links malnutrition with poor outcome in peritoneal dialysis (PD) patients; however, most studies have evaluated Western populations, which may have clinical and demographic characteristics different from those of Asian populations. Although Asian PD patients are generally regarded to have survival superior to that of Western patients, whether that better survival is related to better nutrition in Asian patients is not clear. Past studies suggest that the overall prevalence of protein–calorie malnutrition as assessed by subjective global assessment (SGA)—especially cases of severe malnutrition—seems to be lower in Asian PD patients than in Western patients. Less activation of systemic inflammatory reaction, less comorbidity, lower prevalence of metabolic acidosis, or better compliance may be responsible for better nutritional status in Asian PD patients. Dietary protein and calorie intake, dialysis dose, and membrane transport characteristics appear not to differ significantly between Asian and non Asian PD patients. Mechanisms that explain the lower prevalence of systemic inflammatory reaction in Asian PD patients need to be investigated, along with their possible impacts on nutrition and cardiovascular morbidity and mortality. Large-scale, prospective studies are also necessary to ascertain the exact correlation between dialysis dose and nutritional status, and to determine the dietary protein and calorie intakes that maintain a positive nitrogen balance and better outcome in Asian PD patients.

Icodextrin Improves the Serum Potassium Profile with the Enhancement of Nutritional Status in Continuous Ambulatory Peritoneal Dialysis Patients

“…The hypokalemia seems to most likely be a surrogate marker of malnutrition combined with poor dietary intake of K + . The high prevalence of hypokalemia in CAPD patients, which is consistent with the high prevalence of malnutrition in CAPD patients on conventional GD, has been noted as 18-56% in numerous previous reports 15 , 16) .…”

Change of Nutritional Status Assessed Using Subjective Global Assessment Is Associated With All-Cause Mortality in Incident Dialysis Patients

“…Fourth, the proportion of the severely MN patients (0.7% at baseline) was much lower than the previous studies; therefore, severely MN patients could not be analyzed separately. 14 , 19 This may be attributed to several factors, such as ethnic differences, 31 some degree of residual renal function, 32 , 33 and a relatively long duration of predialysis care by nephrologists (mean 3.6 years). Fifth, anthropometric indices were not included, and thus the predictability of the changes in these indices for mortality was not clarified.…”

Clinical efficacy and feasibility of whey protein isolates supplementation in malnourished peritoneal dialysis patients: A multicenter, parallel, open-label randomized controlled trial

“…Malnutrition in chronic kidney disease (CKD) patients undergoing peritoneal dialysis (PD) is a common issue with global incidence ranging from 18 to 56% [1]. In Malaysia, where continuous ambulatory peritoneal dialysis (CAPD) is the mainstay PD therapy for 3619 patients, about 60% are considered malnourished [2].…”