Nutritional requirements for patients undergoing continuous ambulatory peritoneal dialysis

Recent studies suggest that patients undergoing continuous ambulatory peritoneal dialysis (CAPD) may be prone to develop protein depletion. This paper reviews data concerning glucose uptake, protein and amino acid losses, and nitrogen and mineral balances in clinically stable adult CAPD patients. Approximately 70% of the glucose instilled with dialysate was absorbed, and the glucose absorbed provided approximately 8 kcal/kg/day to the patient. Serum total protein and albumin losses into dialysate averaged 8.8 +/- (SEM) 0.5 and 5.7 +/- 0.4 g/day, respectively. The quantity of free amino acids removed with dialysis was less, 3.4 +/- 0.3 g/day. The balance studies suggest that a safe dietary protein allowance for clinically stable CAPD patients who are ingesting high energy diets is 1.2 to 1.3 g/kg/day. Tentative dietary allowances for other nutrients in clinically stable CAPD patients are proposed.