Dialysis dose and nutrition in Japanese peritoneal dialysis patients

In the present study, we tried to determine the relationship between dialysis dose and nutrition in PD patients. We enrolled 100 Japanese outpatients, including 11 diabetic patients, who were on continuous ambulatory peritoneal dialysis [CAPD (n = 74)] and automated peritoneal dialysis [APD (n = 26)] at 49 local hospitals. In all patients, a peritoneal function test (PET) was performed using the PD NAVI software (JMS, Hiroshima, Japan). The PD NAVI software measured parameters of nutrition and dialysis dose; percentage creatinine generation rate (%CGR); percentage lean body mass normalized to body weight (%LBM); normalized protein nitrogen appearance (nPNA); total fluid removal (TFR), including urine; weekly total Kt/V; and creatinine clearance (CCr). The %CGR correlated linearly with %LBM and nPNA, parameters of the nutrition status of the patients. The %CGR also showed a significant linear correlation with Kt/V, CCr, and TFR. Patients with a %CGR below 100% (the "low group") numbered 37 (32 men, 5 women). The CCr and TFR values in that group were lower than the CCr and TFR values in the other patients (the "high group"). Conclusively, the dialysis dose did not reach the solute clearance values proposed by the National Kidney Foundation Dialysis Outcomes Quality Initiative. That finding may be the result of prescribing and monitoring dialysis therapy based on the PET The %CGR by PD NAVI may become an important index for clinical evaluation of PD dose and optimal dialysis prescription.