Advanced wasting in peritoneal dialysis patients

Area of Science:

• Nephrology
• Clinical Nutrition
• Body Composition Analysis

Background:

• End-stage renal disease (ESRD) patients on peritoneal dialysis (PD) are susceptible to malnutrition.
• Body fat (BF) depletion is a marker of poor prognosis in PD patients.
• Accurate assessment of body composition is crucial for nutritional management in PD.

Purpose of the Study:

• To identify PD patients with zero body fat (BF) using anthropometric formulas for body water (V).
• To compare nutritional parameters between PD patients with zero BF and those with non-zero BF.
• To characterize advanced wasting in the context of PD therapy.

Main Methods:

• Analysis of body composition in 439 PD patients using anthropometric formulas (Watson formulas) to estimate body water (V).
• Definition of advanced wasting as zero BF, calculated when V/0.73 ≥ body weight (W).
• Comparison of nutritional indices (BMI, serum albumin, creatinine) between patients with and without advanced wasting.

Main Results:

• Two male PD patients (0.46%) among 439 were identified with advanced wasting (zero BF).
• These patients exhibited significantly lower body mass index and serum albumin compared to other male PD patients.
• Individual nutritional markers varied, with one patient showing low creatinine and the other elevated creatinine, suggesting potential non-compliance.

Conclusions:

• Advanced wasting (zero BF) is a rare but significant finding in PD patients.
• The anthropometric estimation of body water can identify these patients.
• Zero BF in PD patients is associated with indicators of poor somatic and visceral nutrition, highlighting the need for nutritional support.