NUTRITION AND QUALITY OF LIFE OUTCOMES IN PERITONEAL DIALYSIS – A COMPARISON BETWEEN AUTOMATED AND CONTINUOUS AMBULATORYPERITONEAL DIALYSIS

Abstract

Automated Peritoneal Dialysis (APD) has become the most popular form of peritoneal dialysis (PD) in Australia; however few studies on nutritional status in PD patients have separated APD from CAPD. Therefore the purpose was to assess the nutritional status, oral intake and self rated Quality of Life (QoL) in PD patients and compare between CAPD and APD. 10 adult CAPD and 37 APD patients on home-based peritoneal dialysis for ≥ 3 months had anthropometry measured, nutritional intake calculated from three day food diaries, and Patient Generated Subjective Global Assessment (PG-SGA) completed. QoL was assessed using the Medical Outcomes Study Short Form (SF-36) questionnaire. Overall 48.9% (n=23) were classified as well nourished, 44.7% (n=21) were mild or moderately undernourished, and 6.4% (n=3) were severely undernourished. The proportion of PD patients with energy and protein intake below evidence based guideline targets was 90.2% (n=37) and 70.7% (n=29), respectively. 25.5% (n=12) of patients lost weight and 59.6% (n=28) gained weight from initiation of therapy until date of assessment. Average quality of life score was 50.4±18.7. QoL was correlated with PG-SGA (R2=0.298, p<0.01) with adjustment for age, gender, and length of time on PD. No significant differences were seen between CAPD and APD for PG-SGA mean numerical score, PG-SGA category, or for energy, protein, phosphate and potassium intakes. QoL was not statistically significant between modalities for any of the eight dimensions or total score. In Conclusion, under-nutrition was highly prevalent in this small cohort of PD patients. Energy and protein intakes were below the current Australian recommendation for the majority of the sample. Nutritional status, dietary intakes and QoL outcomes did not differ between stable CAPD and APD patients.