[Comparison of indices of kinetic modelling of urea and creatinine as well as evaluation of nutritional status of patients treated with continuous ambulatory peritoneal dialysis].

The purpose of this study is to evaluate the adequacy of continuous ambulatory peritoneal dialysis (CAPD) using urea and creatinine kinetics as well as nutritional indices in 5 male patients treated with CAPD (111 +/- 9 ml of dialysis solution per kg b.w. per day) during 6.9 +/- 1.3 months. For kinetic evaluation of CAPD the following parameters were used: weekly Kt/V, normalized protein catabolic rate (NPCR, g/kg b.w./day), total creatinine clearance (Cl cr, l/wk/1.73 m2) and efficacy number (1/g cr/day). Dietary protein intake (DPI, g/kg b.w./day), daily energy intake (DEI, kcal/kg b.w.), lean body mass (LBM, % b.w. and plasma albumin (PA, g/dl) were indices of nutrition. Results (mean +/- SD) of kinetic parameters indicate adequate (A), marginal (M) or inadequate (NA) evaluation of CAPD: Kt/V of 1.5 +/- 0.3 (M/NA), NPCR of 0.76 +/- 0.13 (M/NA), Cl cr of 64 +/- 25 (A/M) and EN of 5.9 +/- 0.9 (A/M). Urea and creatinine kinetics were accompanied by DPI of 1.07 +/- 0.35, DEI of 34 +/- 12 and PA of 3.73 +/- 0.38. These parameters, although obtained in overweight patients (LBM of 77 +/- 11% b.w.), indicate marginal nutritional status. Our results show that urea kinetics (Kt/V and NPCR) are more rigorous parameters in evaluation of CAPD adequacy than creatinine kinetics (Cr Cl and EN).