[A longitudinal study of nutritional status in peritoneal dialysing patients].

OBJECTIVE

To investigate the dynamic change and clinically related factors of nutritional status continuous ambulatory peritoneal dialysis (CAPD) patients with a longitudinal study.

METHODS

Nutritional status and nutrition related factors were assessed every 6 months in 43 CAPD patients recruited from during the two years June 2002 to June 2003. Subjective global assessment and serum albumin were examined as nutritional indexes. Nutrition related factors including dialysis adequacy, dietary protein and energy intake (DPI and DEI), inflammatory and volume status, metabolic acidosis and acute and chronic comorbidities were analyzed.

RESULTS

Even though renal Kt/V, Ccr and total Kt/V significantly were decreased in the 43 patients during the 2 years (P = 0.02), the prevalence of malnutrition decreased from 65.12% to 25.58% and serum albumin increased from (34.53 +/- 5.10) g/L to (37.01 +/- 4.39) g/L (P = 0.01). Fourteen of the 43 patients were continually well-nourished, 18 patients switched from malnourished to well-nourished. 3 patients had variable nutritional status and 8 patients continually kept in malnutrition. Patients with variable nutritional status and continual malnutrition had higher CRP, ECW/TBW, nECW levels and a higher prevalence of acute complications (P < 0.05). They also had lower serum albumin and DPI levels than patients with good nutrition (P < 0.05). In a logistic multivariate regression, serum CRP (P = 0.011) and nECW (P = 0.019) were positively correlated with variable nutritional status and continual malnutrition.

CONCLUSION

The nutritional status of 74.4% of the CAPD patients was improved during the 2 years after dialysis. Dietary protein intake deficit, inflammation, volume overload and acute complications maybe related to the variable nutritional status and continual malnutrition in CAPD patients.