Peritoneal transport kinetics correlate with serum albumin but not with the overall nutritional status in CAPD patients

Cueto-Manzano, Alfonso M.; Espinosa, A; Hernández, Ana Lluch; Correa‐Rotter, Ricardo

doi:10.1016/s0272-6386(97)90057-3

Cited by 35 publications

(24 citation statements)

References 17 publications

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“…Table 1 summarizes the patients' data. A nutrition scoring system (adapted from Cueto‐Manzano et al [9]) graded the degree of nutrition: 76.2% of patients were assessed as being malnourished, 47.6% as being mild, 23.8% as being moderate, and 4.8% as being severe. Loss of appetite was found to be the most important factor influencing the nutritional status of these patients.…”

Section: Nutritional Status Of Continuous Ambulatory Peritoneal Dialymentioning

confidence: 99%

Nutritional Problems Associated with End‐Stage Renal Disease in the Developing World

Naicker

2002

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Protein-energy malnutrition is a major problem in dialysis patients. There is increased morbidity and mortality in dialysis patients with malnutrition. There are very few published studies on nutritional parameters and adequacy of dialysis from the developing world and especially from Africa. There was a significant improvement in neuromuscular function and nutrition in 22 hemodialysis patients in Egypt with optimization of dialysis dose and nutritional status. In a study of 82 continuous ambulatory peritoneal dialysis (CAPD) patients in Durban, South Africa, there was a reduction in the number of hospital admissions in adequately dialyzed patients (achieving Kt/V of >2.1). In another study of 84 CAPD patients from the same center, 76.2% of patients were assessed as being malnourished, with loss of appetite being an important etiological factor. Strategies to optimize dialysis dose, together with services of a renal dietician, will assist in improving the nutrition of patients with chronic renal failure.

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Section: Nutritional Status Of Continuous Ambulatory Peritoneal Dialymentioning

confidence: 99%

Nutritional Problems Associated with End‐Stage Renal Disease in the Developing World

Naicker

2002

Artificial Organs

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“…It might be a more cardinal matter in patients on peritoneal dialysis (PD) than those on haemodialysis (HD). It has been reported that those with high RRF among PD patients have advantages in small and middle solute removal, volume control, satisfactory improvement of anaemia with erythropoietin and control of calcium and phosphorous concentrations, and that morbidity and mortality rates are lower than in those with low RRF 1–15 . Bargman et al .…”

Section: Introductionmentioning

confidence: 99%

Preservation of residual renal function and factors affecting its decline in patients on peritoneal dialysis

Hidaka

Nakao

2003

Nephrology

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The decline of residual renal function (RRF) in peritoneal dialysis (PD) patients was analysed and assessed, and risk factors affecting its decline were identified. Residual glomerular filtration rate (GFR) was calculated from averaging the urea and creatinine clearance by 24-h urine collection, and peritoneal solute removal was evaluated by creatinine clearance calculated from 24-h effluent collection. Both GFR and peritoneal solute removal were chronologically examined in 34 PD patients from the time of initiation, and risk factors associated with rapid GFR decline were investigated. The RRF contributed to 43.1 +/- 17.6% of total (peritoneal and renal) weekly creatinine clearance at 1 month after initiation of PD. Residual GFR, however, declined continuously with time (-0.19 +/- 0.14 mL/min per month), and the reduction rate was high with a higher GFR, higher normalized dietary protein intake, higher urine volume and higher urine protein excretion at the initiation of PD. Other factors related to the rapid decline of GFR were: being older than 60 years of age, automated peritoneal dialysis (APD) rather than continuous ambulatory peritoneal dialysis, mean blood pressure higher than 110 mmHg, and serum human atrial natriuretic peptide level higher being than 60 pg/dL. These data suggest that while RRF plays an important role in the removal of uraemic solute in PD patients, they show a significant decrease over 2 years. The factors related to the rapid decline of GFR corresponded to older age, modality of PD (APD), higher GFR and higher amount of urine protein at initiation, higher dietary protein intake, and inadequate control of hypertension and body fluid volume.

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“…Meanwhile, the results of our study revealed that SAD was negatively associated with serum albumin concentrations. Hypoalbuminemia is a common complication in PD patients and the causes of hypoalbuminemia are complex such as aging, malnutrition, ultrafiltration failure, excess protein loss through the peritoneal membrane, and systemic inflammation [43], [44]. Since there was a significant positive association between hs-CRP levels and SAD, and hs-CRP levels were significantly higher in the highest SAD group, we suggested that enhanced inflammation in patients with higher SAD could be a possible reason of hypoalbuminemia in the higher SAD groups.…”

Section: Discussionmentioning

confidence: 99%

Sagittal Abdominal Diameter Is an Independent Predictor of All-Cause and Cardiovascular Mortality in Incident Peritoneal Dialysis Patients

et al. 2013

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Backgrounds and AimsVisceral fat has a crucial role in the development and progression of cardiovascular disease, the major cause of death in end-stage renal disease (ESRD). Although sagittal abdominal diameter (SAD), as an index of visceral fat, significantly correlated with mortality in the general population, the impact of SAD on clinical outcomes has never been explored in ESRD patients. Therefore, we sought to elucidate the prognostic value of SAD in incident peritoneal dialysis (PD) patients.MethodsWe prospectively determined SAD by lateral abdominal X-ray at PD initiation, and evaluated the association of SAD with all-cause and cardiovascular mortality in 418 incident PD patients.ResultsThe mean SAD was 24.5±4.3 cm, and during a mean follow-up of 39.4 months, 97 patients (23.2%) died, and 49.4% of them died due to cardiovascular disease. SAD was a significant independent predictor of all-cause [3rd versus 1st tertile, HR (hazard ratio): 3.333, 95% CI (confidence interval): 1.514–7.388, P = 0.01; per 1 cm increase, HR: 1.071, 95% CI: 1.005–1.141, P = 0.03] and cardiovascular mortality (3rd versus 1st tertile, HR: 8.021, 95% CI: 1.994–32.273, P = 0.01; per 1 cm increase, HR: 1.106, 95% CI: 1.007–1.214, P = 0.03). Multivariate fractional polynomial analysis also showed that all-cause and cardiovascular mortality risk increased steadily with higher SAD values. In addition, SAD provided higher predictive value for all-cause (AUC: 0.691 vs. 0.547, P<0.001) and cardiovascular mortality (AUC: 0.644 vs. 0.483, P<0.001) than body mass index (BMI). Subgroup analysis revealed higher SAD (≥24.2 cm) was significantly associated with all-cause mortality in men, women, younger patients (<65 years), and patients with lower BMI (<22.3 kg/m2).ConclusionsSAD determined by lateral abdominal X-ray at PD initiation was a significant independent predictor of all-cause and cardiovascular mortality in incident PD patients. Estimating visceral fat by SAD could be useful to stratify mortality risk in these patients.

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Peritoneal transport kinetics correlate with serum albumin but not with the overall nutritional status in CAPD patients

Cited by 35 publications

References 17 publications

Nutritional Problems Associated with End‐Stage Renal Disease in the Developing World

Nutritional Problems Associated with End‐Stage Renal Disease in the Developing World

Preservation of residual renal function and factors affecting its decline in patients on peritoneal dialysis

Sagittal Abdominal Diameter Is an Independent Predictor of All-Cause and Cardiovascular Mortality in Incident Peritoneal Dialysis Patients

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