[Clinical study on malnutrition and low take of protein and energy in peritoneal dialysis patients]

To study the prevalence and clinical related factors of malnutrition and low take of protein and energy in peritoneal dialysis patients.

We examined the nutritional status in 90 clinically stable continuous ambulatory peritoneal dialysis (CAPD) patients from four dialysis centers in Beijing, including subjective global assessment (SGA), dietary diaries, direct anthropometry, biochemistry and so on. The social function and psychological status (anxiety and depression) were researched too. These patients were placed in various nutritional categorizes based on SGA (i.e. normal nutrition, mild-to-moderate malnutrition, severe malnutrition). The related factors of malnutrition and low take of protein and energy were analyzed through the multivariate regression methods.

SGA showed the prevalence of malnutrition in our CAPD patients was 47.8%, severe malnutrition 13.3%. The mean dietary protein intake (DPI), dietary energy intake (DEI), arm circumference (AC), triceps skinfold (TSF), arm muscle circumference (AMC), serum albumin (Alb), prealbumin (PA), transferring (TF), the normalized protein equivalent of total nitrogen appearance (nPNA), lean body mass (LBM) and % LBM were significantly different among three groups patients (P < 0.001 approximately 0.05). Logistic multivariate regression analysis revealed that DPI (P < 0.05), DEI (P < 0.05) and Tccr (P < 0.01) are negatively correlated with malnutrition, duration of dialysis (P = 0.12) and diabetes (P < 0.05) positively correlated with malnutrition. The mean DPI and DEI were (0.74 +/- 0.26) g . kg(-1) .d(-1), (113 +/- 29) kJ . kg(-1) . d(-1) respectively. In the linear multivariate regression, anxiety scores (P < 0.01) were negatively correlated with DEI, taking exercise (P < 0.05) positively with DEI and depression scores (P < 0.01) negatively with DPI. There were 72 (80%) patients with anxiety of different grades, 14 (15.6%) patients with depression of different grades.

Malnutrition is prevalence in our CAPD patients. Low take of protein and energy, reduced residual renal function and Tccr, long duration of dialysis and diabetes may remarkably influence on malnutrition in our CAPD patients. Anxiety, depression and less exercise may play an important role in low take of protein and energy.