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

The present study evaluates the influence of the peritoneal transport rate (PTR) on the nutritional status of continuous ambulatory peritoneal dialysis (CAPD) patients. Additionally, protein intake, dialysis adequacy, and other clinical variables were analyzed. Forty-two CAPD patients were concurrently subjected to the peritoneal equilibration test, a nutritional evaluation that included 24-hour dietary recall, and nutritional scoring system that included anthropometric, biochemical, and subjective parameters. Eight patients were high, 14 were high-average, 16 were low-average, and four were low transporters. Nine patients had normal nutritional status; six had mild, nine had moderate, and 18 had severe malnutrition. Malnutrition was inversely correlated (P < 0.05) with body surface, hemoglobin, and residual renal function, but not with PTR (r = 0.14; P = 0.38). In the multivariate analysis, the nutritional status was not predicted by the PTR, protein intake, or dialysis adequacy variables. When serum albumin (SA) level was evaluated as an isolated nutritional indicator, the most significant predictors were dialysate to plasma creatinine ratio at 4 hours (D/P4), body surface area, age, and diabetes mellitus. High transporters receiving a high dose of dialysis displayed a trend of having lower SA levels, whereas low-average transporters receiving a high dose of dialysis showed a trend of have higher SA levels. In conclusion, there was no correlation between PTR and nutritional status. In the multivariate analysis, no association was found between nutritional status and PTR, dialysis adequacy, and protein intake. The best predictors for SA are PTR, body surface area, age, and diabetes mellitus. (C) 1997 by the National Kidney Foundation, Inc.