ABSTRACT
OBJECTIVE: To determine if a diet complemented with calcium caseinate is better than a natural high protein diet for increasing serum albumin levels in patients on continuous ambulatory peritoneal dialysis (CAPD). PATIENTS AND METHODS: A 4-month clinical trial involving 100 patients older than 18 years was performed. Patients were randomized into two groups: group A, high protein diet (1.4 g natural protein/kg target weight/day and 35 kcal/kg target weight/day); and group B, calcium caseinate (0.7 g calcium caseinate plus 0.7 g natural protein diet/kg target weight/day and 35 kcal/kg target weight/day). Serum levels of albumin, total proteins (TP), BUN, creatinine, glucose, urea, sodium, and potassium, and hematocrit, leukocytes, erythrocytes, and hemoglobin were analyzed at baseline and every 30 days. RESULTS: The final mean albumin value was, for group A, 3.04 +/- 0.39 g/dL, and for group B, 3.12 +/- 0.41 g/dL (p < 0.05); TP for group A, 6.29 +/- 0.47 g/dL, and for group B, 6.49 +/- 0.51 g/dL (p < 0.05); leukocytes for group A, 6888 +/- 1282/mm3, for group B, 7288 +/- 1878/mm3 (p = 0.05); BUN for group A, 47 +/- 11 mg/dL, for group B, 50 +/- 16 mg/dL (p = 0.05). Regression analysis showed a treatment effect in serum albumin and TP levels from the third month in both groups. In group B, a constant elevation of serum albumin of 0.19 mg/dL and TP of 0.27 mg/dL was observed in every month of treatment with calcium caseinate. In the regression analysis of group A we observed a smaller increase in serum albumin, 0.06 mg/dL, and in TP, 0.11 mg/dL, in each month of treatment with the high protein diet. Both differences are significant (p < 0.05). CONCLUSION: Calcium caseinate used in CAPD patients suffering from malnutrition increases serum albumin levels.
