P1169NUTRITIONAL STATUS OF PATIENTS IN PERITONEAL DIALYSIS: TWO METHODS COMPARED. (6th June 2020)

• Record Type: Journal Article
• Authors: Paribello, Giuseppe; Di Gruttola, Oto; Paduano, Immacolata Gaia; Migliaccio, Silvia; Argentino, Gennaro; Sannino, Giuseppina; Russo, Domenico
• Is Part Of: Nephrology dialysis transplantation. Volume 35(2020)Supplement 3
• Publication Date: 2020-06-06
• Subjects: Nephrology -- Periodicals; Hemodialysis -- Periodicals; Kidneys -- Transplantation -- Periodicals; Hemodialysis; Kidneys -- Transplantation; Nephrology; Periodicals; 616.61
• DOI: 10.1093/ndt/gfaa142.P1169
• Languages: English
• ISSNs: 0931-0509

Abstract

Abstract: Background and Aims: Nutritional status and survival are closely related: a state of undernutrition favors the onset of fatal and non-fatal events. This association becomes even more important in the dialysis patient in which a vicious circle is generated in which undernutrition worsens the basic condition. The issue of our study is to evaluate the nutritional status of patients on peritoneal dialysis (PD) comparing the two methods (CAPD-APD). Method: We evaluated 36 PD patients whose characteristics are reassumed in Tab1. In these patients, dialysis adequacy was assessed by Kt/v and nutritional status through biochemical parameters and the following scores (Tab.2): PCR (Protein catabolic rate) PEW (Protein energy waste) GNRI (Geriatric nutritional risk index) CONUT (Controlling nutritional status score) Results: The data collected shows that 29 patients have a dialysis adequacy compliant with that proposed by the international guidelines (Kt/v ≥ 1.7), of the 7 patients who do not achieve this adequacy 4 are in CAPD and 3 in APD. From a nutritional point of view we consider the ideal PCR of about 1.2 g/kg weight, but this value is difficult to reach by many patients; therefore, a value of at least 0.8 g/Kg/day is considered acceptable. This target is reached by 26 patients; of the 10 patients who do not reach it, 3 are in CAPD and 7 in APD. Analyzing the two methods separately, we can observe that in the CAPD patients the PCR is significantly higher (p <0.002). As regards GNRI, a score <92 is considered as an indicator of an unfavorable prognosis; in this case we can observe that only 3 patients have a score <92, all in APD without however a significant difference between the two methods (p <0.36). Taking into account the reference values for PEW (Tab2) we can highlight the difference between the two methods in the number of patients with a moderate/severe undernutrition status: 13 in APD vs 6 in CAPD. The same can be said for CONUT where an important state of undernutrition is observed in 4 patients in APD vs 1 single patient in CAPD. Conclusion: The study shows how the combined use of multiple parameters is fundamental in managing of patients nutritional status in peritoneal dialysis. The overall analysis of the scores used has shown a greater risk of malnutrition in APD patients in which is necessary to monitor carefully nutritional status, eating habits and lifestyle.