NUTRITIONAL PROFILE OF CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS PATIENTS

Undernutrition in dialysis patients contributes to their morbidity and mortality. This is a cross-sectional study of the nutritional status of 61 patients treated with continuous ambulatory peritoneal dialysis (CAPD). They were studied with emphasis on assessment of their nutritional intake, anthropometric measurements, and evaluation of biochemical parameters. The correlation between the rate of CAPD peritonitis and these measurements was also examined. The majority of the patients (63.1%) had inadequate protein intake (less than or equal to 1.2 g/kg/day). A comparable percentage had a low energy intake(less than or equal to 30 kcal/kg/day). Moderate malnutrition, as assessed by a low triceps skinfold thickness (TST) or a reduced midarm muscle circumference (MAMC) of less than or equal to 20th percentile, was detected in 52% and 39% of the patients, respectively. Severe malnutrition (TST or MAMC less than or equal to 10th percentile) was present in 36% of the patients. The serum insulin-like growth factor I (IGF-I) proved to be the most useful biochemical marker of malnutrition. It showed a positive correlation with TST (r = 0.325; p < 0.05). No significant correlation was observed with other short-life proteins such a transferrin or prealbumin. However, stepwise regression analysis showed the predictive value of serum IGF-I for anthropometric values to be low (adjusted R(2) = 34.6%), Wasted patients did not appear to have more infections when compared to their healthier counterparts. However, a weak correlation was observed between TST and the number of peritonitis episodes. In conclusion, we have confirmed the high prevalence of malnutrition in our population of CAPD patients, identified a low intake of nutrients as a contributing factor, and examined the value of serum ICF-I as a marker of the nutritional status.