Cross-sectional comparison of malnutrition in continuous ambulatory peritoneal dialysis and hemodialysis patients

Bruno Cianciaruso*, Giuliano Brunori, Joel D. Kopple, Giacomo Traverso, Giacomo Panarello, Giuseppe Enia, Paolo Strippoli, Amedeo De Vecchi, Mario Querques, Giusto Viglino, Edward Vonesh, Rosario Maiorca

*Corresponding author for this work

Research output: Contribution to journalArticle

177 Scopus citations

Abstract

Although malnutrition is not uncommon in continuous ambulatory peritoneal dialysis (CAPD) and maintenance hemodialysis (MHD) patients, there has never been a large-scale comparison study of nutritional status with these two dialysis modalities. We therefore assessed protein-calorie nutrition in 224 CAPD patients and 263 MHD patients who were treated in eight centers in Italy. The CAPD patients were slightly older than the MHD patients (60.2 ± 14.2 years v 56.3 ± 15.1 years; P <0.01), had undergone dialysis for less time (2.32 ± 2.10 years v 3.66 ± 2.66 years; P <0.0001), and had higher residual renal function (1.83 ± 2.29 mL/min v 0.27 ± 0.91 mL/min; P <0.0001). Protein nitrogen appearance was 60.5 ± 16.6 g/d and 61.9 ± 16.5 g/d in the CAPD and MHD patients, respectively. In CAPD versus MHD patients, serum total protein and albumin tended to be lower; serum transferrin and mid-arm muscle circumference were similar; and relative body weight, skinfold thickness, and estimated percent body fat tended to be greater. These greater values in CAPD patients were particularly evident in those who were 65 years of age or older. Serum glucose, total cholesterol, and triglycerides also were greater in CAPD patients. The subjective global nutritional assessment indicated a significantly greater proportion of malnourished CAPD patients than MHD patients (42.3% v 30.8%). The greater prevalence of malnutrition in CAPD patients diminished with age. Maintenance hemodialysis patients older than 76 years were more likely to be malnourished than CAPD patients. In patients less than 65 years of age, protein-calorie malnutrition was more likely to be present in CAPD patients than in MHD patients.

Original languageEnglish (US)
Pages (from-to)475-486
Number of pages12
JournalAmerican Journal of Kidney Diseases
Volume26
Issue number3
DOIs
StatePublished - Jan 1 1995

Keywords

  • Continuous ambulatory peritoneal dialysis
  • hemodialysis
  • nutritional status
  • protein-calorie malnutrition
  • subjective global nutritional assessment

ASJC Scopus subject areas

  • Nephrology

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