Abstract
Aim: Malnutrition is common in peritoneal dialysis (PD) patients and hypoalbuminemia is a predictor of poor outcomes in end-stage renal disease patients. Amino acid peritoneal dialysate (AAPD) is used to improve nutritional status in malnourished PD patients. In this study, we investigated effects of AAPD on nutritional parameters in hypoalbuminemic PD patients. Methods: Sixteen (10 male and 6 female) patients, mean age 53.3±11.5 years old (range 36 to 70 years), mean dialysis duration 40.1 ± 31.0 months (range 4 to 99 months) and with serum albumin ≤ 3.9 g/dL were included in the study. Baseline and after three months of AAPD usage, nutritional parameters including, serum albumin, semiquantitative method of subjective global assessment (SGA), normalized protein catabolic rate (n-PCR) and lean body mass (LBM) were compared to evaluate the effects of AAPD on nutritional parameters in PD patients. Results: Thirteen patients completed the study. AAPD was well tolerated. After treatment blood urea nitrogen (BUN), albumin, n-PCR levels and SGA value increased. Serum albumin levels increased in 11 of 13 (84%) patients. However HDL cholesterol and creatinine clearance (CCr) decreased after AAPD. Conclusion: Amino acid peritoneal dialysate is an effective agent to improve nutritional status in PD patients and it is well tolerated. This is the second report about AAPD treatment showing the decrease in HDL cholesterol as a side effect. The mechanism and the effect of decreased HDL cholesterol need to be investigated in PD patients in larger and long-term studies.
Highlights
Malnutrition is associated with reduced protein-energy intake and has many effects on the clinical condition [1]
Amino acid peritoneal dialysate is an effective agent to improve nutritional status in peritoneal dialysis (PD) patients and it is well tolerated. This is the second report about Amino acid peritoneal dialysis (AAPD) treatment showing the decrease in HDL cholesterol as a side effect
The mechanism and the effect of decreased HDL cholesterol need to be investigated in PD patients in larger and long-term studies
Summary
Malnutrition is associated with reduced protein-energy intake and has many effects on the clinical condition [1]. It is well documented that protein-energy malnutrition is common among patients with chronic renal failure (CRF) [2, 3]. The prevalence of malnutrition is reported to be 40-54% in peritoneal dialysis (PD) patients [4,5,6]. The etiology of malnutrition in CRF is complex and includes many factors such as poor food intake, inflammation, gastrointestinal symptoms (nausea and vomiting), metabolic acidosis and increased resting energy expenditure. Amino acid peritoneal dialysis (AAPD) solutions have been used in PD patients to improve nutritional status. In hypoalbuminemic PD patients, some studies showed that serum albumin levels increased with AAPD solution [9, 10] but others not [11]. We investigated the effects of AAPD on nutritional status in hypoalbuminemic PD patients
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