Relationship of peritoneal membrane transport characteristics to the nutritional status in CAPD patients

Duk Hee Kang, Kyun Il Yoon, Kyu Bog Choi, Rutha Lee, Ho Yung Lee, Dae Suk Han, Eun Young Cho, Jong Ho Lee

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Abstract

Background. The study was carried out to evaluate the role of individual peritoneal membrane transport characteristics in the nutritional status expressed as the composite nutritional index (CNI). Methods. Cross-sectional analyses of the overall nutritional status of 147 continuous ambulatory peritoneal dialysis (CAPD) patients were performed using the CNI. CNIs based on a scoring system of 10 nutritional indices including subjective global assessment, biochemical parameters and anthropometry were compared according to the results of a standard peritoneal equilibration test (PET). Results. Patients were classified as low (n = 16, 10.9%), low average (n = 59, 40.2%), high average (n = 54, 36.7%) and high (n = 18, 12.2%) transporters based on the D/P(Cr) after 4 h dwells. The mean 4 h D/P(Cr) was 0.65 ± 0.12 (0.34-0.95), and there was no significant correlation between D/P(Cr) and other demographic parameters such as age, duration of peritoneal dialysis and body surface area. D/P(Cr) was correlated with dialytic albumin loss (r = 0.47, P < 0.001), serum albumin (r = -0.46, P < 0.001), serum creatinine (r = -0.38, P < 0.001), serum IGF-1 (r = -0.37, P < 0.01) and LBM(Cr) (r = -0.26, P < 0.05). In high transporters, the serum albumin was significantly lower while dialysate protein and albumin losses were significantly greater compared with low transporters. Serum creatinine and IGF-1 concentrations as well as LBM(Cr) were also decreased in higher transporters. The mean CNI score was 8.1 ± 4.9, with a range of 0-24. CNI was positively correlated with age, duration of peritoneal dialysis, incidence of peritonitis, CRP and dialytic protein loss, whereas it was inversely correlated with ultrafiltration volume, haemoglobin and NPNA. The CNI score was significantly higher in high transporters compared with low transporters (11.7 ± 4.3 vs. 5.9 ± 1.6, P < 0.01). There was also a significant correlation between D/P(Cr) and CNI (r = 0.29, P < 0.05). Multiple regression analysis revealed that the incidence of peritonitis, duration of CAPD, CRP and D/P(Cr) were the independent factors affecting the CNI. Conclusion. Peritoneal membrane transport characteristics correlate with the overall nutritional status of peritoneal dialysis patients assessed by the scoring system of the CNI, although it is associated with a different impact on the individual nutritional indices. The results of this cross-sectional study also suggest that a high permeability state is a risk factor for malnutrition in CAPD patients. Prospective studies evaluating the changes in nutritional parameters among patients with different membrane transport rates are needed to understand better the relationship of peritoneal membrane characteristics to the nutritional status of CAPD patients.

Original languageEnglish
Pages (from-to)1715-1722
Number of pages8
JournalNephrology Dialysis Transplantation
Volume14
Issue number7
DOIs
Publication statusPublished - 1999 Jul 17

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Nutrition Assessment
Continuous Ambulatory Peritoneal Dialysis
Nutritional Status
Membranes
Peritoneal Dialysis
Peritonitis
Insulin-Like Growth Factor I
Serum Albumin
Albumins
Creatinine
Cross-Sectional Studies
Serum
Anthropometry
Body Surface Area
Dialysis Solutions
Incidence
Ultrafiltration
Malnutrition
Permeability
Hemoglobins

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Transplantation

Cite this

Kang, Duk Hee ; Yoon, Kyun Il ; Choi, Kyu Bog ; Lee, Rutha ; Lee, Ho Yung ; Han, Dae Suk ; Cho, Eun Young ; Lee, Jong Ho. / Relationship of peritoneal membrane transport characteristics to the nutritional status in CAPD patients. In: Nephrology Dialysis Transplantation. 1999 ; Vol. 14, No. 7. pp. 1715-1722.
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abstract = "Background. The study was carried out to evaluate the role of individual peritoneal membrane transport characteristics in the nutritional status expressed as the composite nutritional index (CNI). Methods. Cross-sectional analyses of the overall nutritional status of 147 continuous ambulatory peritoneal dialysis (CAPD) patients were performed using the CNI. CNIs based on a scoring system of 10 nutritional indices including subjective global assessment, biochemical parameters and anthropometry were compared according to the results of a standard peritoneal equilibration test (PET). Results. Patients were classified as low (n = 16, 10.9{\%}), low average (n = 59, 40.2{\%}), high average (n = 54, 36.7{\%}) and high (n = 18, 12.2{\%}) transporters based on the D/P(Cr) after 4 h dwells. The mean 4 h D/P(Cr) was 0.65 ± 0.12 (0.34-0.95), and there was no significant correlation between D/P(Cr) and other demographic parameters such as age, duration of peritoneal dialysis and body surface area. D/P(Cr) was correlated with dialytic albumin loss (r = 0.47, P < 0.001), serum albumin (r = -0.46, P < 0.001), serum creatinine (r = -0.38, P < 0.001), serum IGF-1 (r = -0.37, P < 0.01) and LBM(Cr) (r = -0.26, P < 0.05). In high transporters, the serum albumin was significantly lower while dialysate protein and albumin losses were significantly greater compared with low transporters. Serum creatinine and IGF-1 concentrations as well as LBM(Cr) were also decreased in higher transporters. The mean CNI score was 8.1 ± 4.9, with a range of 0-24. CNI was positively correlated with age, duration of peritoneal dialysis, incidence of peritonitis, CRP and dialytic protein loss, whereas it was inversely correlated with ultrafiltration volume, haemoglobin and NPNA. The CNI score was significantly higher in high transporters compared with low transporters (11.7 ± 4.3 vs. 5.9 ± 1.6, P < 0.01). There was also a significant correlation between D/P(Cr) and CNI (r = 0.29, P < 0.05). Multiple regression analysis revealed that the incidence of peritonitis, duration of CAPD, CRP and D/P(Cr) were the independent factors affecting the CNI. Conclusion. Peritoneal membrane transport characteristics correlate with the overall nutritional status of peritoneal dialysis patients assessed by the scoring system of the CNI, although it is associated with a different impact on the individual nutritional indices. The results of this cross-sectional study also suggest that a high permeability state is a risk factor for malnutrition in CAPD patients. Prospective studies evaluating the changes in nutritional parameters among patients with different membrane transport rates are needed to understand better the relationship of peritoneal membrane characteristics to the nutritional status of CAPD patients.",
author = "Kang, {Duk Hee} and Yoon, {Kyun Il} and Choi, {Kyu Bog} and Rutha Lee and Lee, {Ho Yung} and Han, {Dae Suk} and Cho, {Eun Young} and Lee, {Jong Ho}",
year = "1999",
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Relationship of peritoneal membrane transport characteristics to the nutritional status in CAPD patients. / Kang, Duk Hee; Yoon, Kyun Il; Choi, Kyu Bog; Lee, Rutha; Lee, Ho Yung; Han, Dae Suk; Cho, Eun Young; Lee, Jong Ho.

In: Nephrology Dialysis Transplantation, Vol. 14, No. 7, 17.07.1999, p. 1715-1722.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Relationship of peritoneal membrane transport characteristics to the nutritional status in CAPD patients

AU - Kang, Duk Hee

AU - Yoon, Kyun Il

AU - Choi, Kyu Bog

AU - Lee, Rutha

AU - Lee, Ho Yung

AU - Han, Dae Suk

AU - Cho, Eun Young

AU - Lee, Jong Ho

PY - 1999/7/17

Y1 - 1999/7/17

N2 - Background. The study was carried out to evaluate the role of individual peritoneal membrane transport characteristics in the nutritional status expressed as the composite nutritional index (CNI). Methods. Cross-sectional analyses of the overall nutritional status of 147 continuous ambulatory peritoneal dialysis (CAPD) patients were performed using the CNI. CNIs based on a scoring system of 10 nutritional indices including subjective global assessment, biochemical parameters and anthropometry were compared according to the results of a standard peritoneal equilibration test (PET). Results. Patients were classified as low (n = 16, 10.9%), low average (n = 59, 40.2%), high average (n = 54, 36.7%) and high (n = 18, 12.2%) transporters based on the D/P(Cr) after 4 h dwells. The mean 4 h D/P(Cr) was 0.65 ± 0.12 (0.34-0.95), and there was no significant correlation between D/P(Cr) and other demographic parameters such as age, duration of peritoneal dialysis and body surface area. D/P(Cr) was correlated with dialytic albumin loss (r = 0.47, P < 0.001), serum albumin (r = -0.46, P < 0.001), serum creatinine (r = -0.38, P < 0.001), serum IGF-1 (r = -0.37, P < 0.01) and LBM(Cr) (r = -0.26, P < 0.05). In high transporters, the serum albumin was significantly lower while dialysate protein and albumin losses were significantly greater compared with low transporters. Serum creatinine and IGF-1 concentrations as well as LBM(Cr) were also decreased in higher transporters. The mean CNI score was 8.1 ± 4.9, with a range of 0-24. CNI was positively correlated with age, duration of peritoneal dialysis, incidence of peritonitis, CRP and dialytic protein loss, whereas it was inversely correlated with ultrafiltration volume, haemoglobin and NPNA. The CNI score was significantly higher in high transporters compared with low transporters (11.7 ± 4.3 vs. 5.9 ± 1.6, P < 0.01). There was also a significant correlation between D/P(Cr) and CNI (r = 0.29, P < 0.05). Multiple regression analysis revealed that the incidence of peritonitis, duration of CAPD, CRP and D/P(Cr) were the independent factors affecting the CNI. Conclusion. Peritoneal membrane transport characteristics correlate with the overall nutritional status of peritoneal dialysis patients assessed by the scoring system of the CNI, although it is associated with a different impact on the individual nutritional indices. The results of this cross-sectional study also suggest that a high permeability state is a risk factor for malnutrition in CAPD patients. Prospective studies evaluating the changes in nutritional parameters among patients with different membrane transport rates are needed to understand better the relationship of peritoneal membrane characteristics to the nutritional status of CAPD patients.

AB - Background. The study was carried out to evaluate the role of individual peritoneal membrane transport characteristics in the nutritional status expressed as the composite nutritional index (CNI). Methods. Cross-sectional analyses of the overall nutritional status of 147 continuous ambulatory peritoneal dialysis (CAPD) patients were performed using the CNI. CNIs based on a scoring system of 10 nutritional indices including subjective global assessment, biochemical parameters and anthropometry were compared according to the results of a standard peritoneal equilibration test (PET). Results. Patients were classified as low (n = 16, 10.9%), low average (n = 59, 40.2%), high average (n = 54, 36.7%) and high (n = 18, 12.2%) transporters based on the D/P(Cr) after 4 h dwells. The mean 4 h D/P(Cr) was 0.65 ± 0.12 (0.34-0.95), and there was no significant correlation between D/P(Cr) and other demographic parameters such as age, duration of peritoneal dialysis and body surface area. D/P(Cr) was correlated with dialytic albumin loss (r = 0.47, P < 0.001), serum albumin (r = -0.46, P < 0.001), serum creatinine (r = -0.38, P < 0.001), serum IGF-1 (r = -0.37, P < 0.01) and LBM(Cr) (r = -0.26, P < 0.05). In high transporters, the serum albumin was significantly lower while dialysate protein and albumin losses were significantly greater compared with low transporters. Serum creatinine and IGF-1 concentrations as well as LBM(Cr) were also decreased in higher transporters. The mean CNI score was 8.1 ± 4.9, with a range of 0-24. CNI was positively correlated with age, duration of peritoneal dialysis, incidence of peritonitis, CRP and dialytic protein loss, whereas it was inversely correlated with ultrafiltration volume, haemoglobin and NPNA. The CNI score was significantly higher in high transporters compared with low transporters (11.7 ± 4.3 vs. 5.9 ± 1.6, P < 0.01). There was also a significant correlation between D/P(Cr) and CNI (r = 0.29, P < 0.05). Multiple regression analysis revealed that the incidence of peritonitis, duration of CAPD, CRP and D/P(Cr) were the independent factors affecting the CNI. Conclusion. Peritoneal membrane transport characteristics correlate with the overall nutritional status of peritoneal dialysis patients assessed by the scoring system of the CNI, although it is associated with a different impact on the individual nutritional indices. The results of this cross-sectional study also suggest that a high permeability state is a risk factor for malnutrition in CAPD patients. Prospective studies evaluating the changes in nutritional parameters among patients with different membrane transport rates are needed to understand better the relationship of peritoneal membrane characteristics to the nutritional status of CAPD patients.

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