Nutritional status and body composition after 6 months of patients switching from continuous ambulatorial peritoneal dialysis to automated peritoneal dialysis

Abstract

Our objective was to determine if automated peritoneal dialysis (APD) leads to changes in nutritional parameters of patients treated by continuous ambulatory peritoneal dialysis (CAPD). Twenty-six patients (15 males; 50.5 ± 14.3 years) were evaluated during CAPD while training for APD and after 3 and 6 months of APD. Body fat was assessed by the sum of skinfold thickness and the other body compartments were assessed by bioelectrical impedance. During the 6-month follow-up, 12 patients gained more than 1 kg (GW group), 8 patients lost more than 1 kg (LW group), and 6 patients maintained body weight (MW group). Except for length on dialysis that was longer for the LW group compared with the GW group, no other differences were found between the groups at baseline. After 6 months on APD, the LW group had a reduction in body fat (24.5 ± 7.7 vs 22.1 ± 7.3 kg; P = 0.01), body cell mass (22.6 ± 6.2 vs 21.6 ± 5.8 kg, P = 0.02) and phase angle (5.4 ± 0.9 vs 5.1 ± 0.8 degrees, P = 0.004). In the GW group, body fat (25 ± 7.6 vs 27.2 ± 7.6 kg, P = 0.001) and body cell mass (20.1 ± 3.9 vs 20.8 ± 4.0 kg, P = 0.05) were increased. In the present study, different patterns of change in body composition were found. The length of previous dialysis treatment seems to be the most important factor in determining these nutritional modifications.

Application of Bioelectrical Impedance Analysis in Nutritional Management of Patients with Chronic Kidney Disease

“…The LW group had a reduction in fat mass (FM) and body cell mass (BCM). In the GW group, FM and BCM increased [ 82 ]. One study followed up PD patients for 1 year, and found that in the GW group, the increase in FM was the most obvious, while all components in the LW group decreased simultaneously, including intracellular water (ICW), extracellular water (ECW), fat mass (FM), body protein volume (BPV), and bone mineral content (BMC) [ 83 ].…”

“…Six months after the start of peritoneal dialysis (PD), the patient’s phase angle (PhA) decreased significantly [ 82 ]. However, one study showed that PhA in the PD group was higher than that in the CKD5 group before dialysis [ 43 ].…”

Association of metabolic changes with mortality of patients treated by peritoneal dialysis or hemodialysis

“…[17][18][19] Williams et al 20 found no proof that PD patients are more obese than those on HD, and -what is more important -that obesity of dialysis patients is not correlated with increased risk of getting CVD for the general population. On the contrary, low BMI and other parameters of underfeeding were strong independent indicators of mortality for dialysis patients.…”

Application of bioelectrical impedance analysis in nutritional management of patients with chronic kidney disease

“…In the LW group had a reduction in fat mass (FM), body cell mass (BCM). In the GW group, FM and BCM were increased [82]. One study followed up PD patients for 1 year, and found that in the GW group, the increase of FM was the most obvious, while all components in the LW group decreased simultaneously, including intracellular water (ICW), extracellular water (ECW), fat mas (FM), body protein volume (BPV), and bone mineral content (BMC) [83].…”

“…Six months after the start of peritoneal dialysis (PD), the patient's phase angle (PhA) decreased significantly [82]. However, one study showed that PhA in PD group was higher than that in CKD5 group before dialysis [43].…”