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Nutritional and metabolic studies in children on continuous ambulatory peritoneal dialysis

M Broyer, P Niaudet, G Champion

    Kidney International. Supplement
    |November 1, 1983
    PubMed

    Insights

    Continuous ambulatory peritoneal dialysis (CAPD) in children and adolescents may lead to decreased plasma albumin levels, particularly in younger patients. This reduction is linked to protein loss during dialysis, not dietary intake.

    Area of Science:

    • Pediatric Nephrology
    • Clinical Nutrition
    • Renal Replacement Therapy

    Background:

    • Continuous ambulatory peritoneal dialysis (CAPD) is a treatment for end-stage renal disease in children.
    • Nutritional status and protein balance are critical concerns during CAPD therapy.
    • Understanding the impact of CAPD on pediatric patients' biochemical parameters is essential for optimizing care.

    Purpose of the Study:

    • To evaluate the effects of CAPD on plasma albumin and amino acid levels in pediatric patients.
    • To investigate the relationship between peritoneal protein loss and nutritional markers.
    • To assess changes in glucose metabolism and lipid profiles during CAPD.

    Main Methods:

    • A longitudinal study was conducted on 15 children and adolescents undergoing CAPD for 6-24 months.
    • Plasma albumin, free amino acids, cholesterol, and triglycerides were measured.
    • Oral glucose tolerance tests were performed.
    • Peritoneal protein loss and dietary protein intake were assessed.

    Main Results:

    • Plasma albumin concentration decreased significantly over 19-24 months of CAPD.
    • Younger children (<6 years) exhibited lower baseline albumin levels compared to older children.
    • Peritoneal protein loss correlated with lower plasma albumin, independent of protein intake.
    • Plasma cholesterol and triglycerides were elevated, correlating with peritoneal protein loss.

    Conclusions:

    • CAPD in pediatric patients is associated with a decline in plasma albumin, primarily due to peritoneal protein loss.
    • Nutritional management should consider the increased protein losses in children on CAPD.
    • Elevated lipid profiles require monitoring and potential intervention in pediatric CAPD patients.

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