Protein-Energy Requirements of Children and Adolescents on CAPD.Preliminary Results of Nitrogen Balance Studies

Santo, Natale G. De; Capodicasa, G; Pluvio, M; Giugliano, Dario; Torella, Roberto; Giordano, C

doi:10.1007/978-94-009-8319-9_26

Cited by 6 publications

(3 citation statements)

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“…Likewise, we also observed the reverse situation when some patients with lower glucose exposure than others had higher glucose absorption, mainly due either to longer dwell times or difference in membrane transport characteristics (Table 3). Overall, the daily amount of glucose absorption and the consequent caloric load was much lower in our patients compared to that observed in earlier studies, which were done in CAPD patients (1,4,11,12). Lower glucose absorption in contemporary PD patients using cycler is likely because of lower dwell times and avoidance of 4.25% dextrose dialysate solutions.…”

Section: Discussioncontrasting

confidence: 52%

A Model To Estimate Glucose Absorption in Peritoneal Dialysis: A Pilot Study

Kotla

Saxena

2020

Kidney360

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Background: Glucose absorption in peritoneal dialysis (PD) patients may contribute to adverse metabolic effects. Previous studies on glucose absorption were done on continuous ambulatory PD (CAPD) patients, with long dwell time. However, the growing majority of contemporary PD patients perform automated peritoneal dialysis with short dwell time. Moreover, membrane characteristics and dwell time determine small solute transport across the peritoneal membrane. Methods: In our pilot study, we used data from peritoneal equilibration test (PET) to develop a model to estimate glucose absorption. In six randomly selected PD patients, we calculated actual glucose absorption from directly measuring effluent glucose concentration. We then used R programming language to create non-linear least squared regression model inputting PET data, D2/D0 and D4/D0 to generate exponential decay curve. This model was then utilized to estimate the fraction of glucose remaining in the dialysate at a particular dwell time t (Dt/D0). Daily glucose absorption was calculated by multiplying 1-Dt/D0 with the amount of glucose the patient was exposed to in 24 hours. Results: We observed the mean glucose absorption (89.7 ± 28.8 g/d) as measured from the effluent very close to our estimate (88.12 ± 28.9 g/d) and the difference between the glucose estimation and actual absorption was not statistically significant (p>0.05). After validating our hypothesis, we randomly selected an independent cohort of 11 ESRD patients on various PD modalities and analyzed the data. We observed that mean daily glucose absorption of 62.7 ± 24.5 g (27.98-110.35 g), much lower than that reported in the literature and depends upon dwell times and membrane characteristics in addition of amount of glucose exposure. Conclusions: Our model provides a simple tool to estimate glucose absorption and caloric load in contemporary PD patients. Hopefully, accurate estimation of caloric load and incorporating it in the

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Section: Discussioncontrasting

confidence: 52%

A Model To Estimate Glucose Absorption in Peritoneal Dialysis: A Pilot Study

Kotla

Saxena

2020

Kidney360

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“…Clinical experience with some 50 uremic children and infants suggests a definite role for CAPO (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11), but its wider adoption requires an answer to the question whether adequate growth can be obtained with this modality of treatment. On the basis of careful measurements in 36 children, some preliminary observations can now be made on this important issue.…”

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confidence: 99%

Growth during Continuous Ambulatory Peritoneal Dialysis (CAPD)

et al. 1982

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“…Markers of protein metabolism in pediatric PD duration, resulting in incomplete stabilization of nitrogen patients are age dependent and differ from adult values. An intake, and have not provided sufficient data to utilize urea age-specific relationship between TNA and UNA is defined for nitrogen and TNA interchangeably [22][23][24]. Thus, we pediatric subjects; it does not vary with rhGH or the presence of sought to determine a predictable relationship between residual renal function.urea nitrogen and total nitrogen excretion to facilitate nutritional assessment in this patient population, which…”

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confidence: 99%