THE PRELIMINARY STUDY ON THE MECHANISM OF MALNUTRITION IN PERITONEAL DIALYSIS PATIENTS / 营养学报

ABSTRACT

Objective: To study the possible mechanism of malnutrition in peritoneal dialysis patients. Methods: Multicenter prospective cohort study was designed . Forty-four peritoneal dialysis patients who survived two years after a cross-sectional study were included in the present study. We divided our patients into two groups according to the dietary protein intake(DPI) during follow-up period, DPI lower than 0.78 g/( kg?d) or DPI higher than 0.78 g/( kg?d). Patients' nutritional status was evaluated during the cross-sectional study and at the end of follow-up. 22 patients were divided into two groups according to the nutritional status improved or worsened in subjective global assessment (SGA) during the follow-up period. Besides nutritional status, patient's residual renal function, volume status and the incidence of cardiovascular event during the follow-up period were also evaluated. Results: Based on SGA , the incidence of malnutrition in low-DPI group was 60.9% in the cross-sectioned study and 45.5% after the follow-up. In high-DPI group, it decreased from 57.1% to 28.6%. The residual renal function declined significantly in worse nutritional status group, the incidences of volume overload and cardiovascular events during follow-up study were significantly higher in worse nutritional status group than that in improved nutritional status group. Conclusion: Malnutrition in peritoneal dialysis patients may not be simply due to lower protein intake. The changes in residual renal function, fluid overload and cardiovascular disease, accompanied with low dietary protein intake may be the possible cause of malnutrition in peritoneal dialysis patients.