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Total body nitrogen as a prognostic marker in maintenance dialysis
C A Pollock1, L S Ibels, B J Allen
1Department of Renal Medicine, Royal North Shore Hospital, St. Leonards, Australia.
Journal of the American Society of Nephrology : JASN
|July 1, 1995
Summary
Total body nitrogen (TBN) levels decline in hemodialysis patients over time, while increasing in continuous ambulatory peritoneal dialysis patients. Low TBN is linked to increased mortality risk in dialysis patients.
Area of Science:
- Nephrology
- Nutritional Science
- Biochemistry
Background:
- Long-term nutritional adequacy is crucial for patients undergoing maintenance dialysis.
- Assessing body composition and nutritional status is vital for managing end-stage renal disease.
Purpose of the Study:
- To evaluate long-term nutritional status in patients on hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD).
- To investigate the relationship between total body nitrogen (TBN) and mortality risk in dialysis patients.
Main Methods:
- 154 patients on maintenance dialysis (78 HD, 76 CAPD) had TBN measured, alongside dietary history, anthropometrics, and serum albumin.
- 71 patients were reassessed after a mean of 23.3 months.
- Total body nitrogen index was calculated and correlated with mortality.
Main Results:
- Hemodialysis patients showed a significant decrease in TBN over time.
- Continuous ambulatory peritoneal dialysis patients demonstrated a significant increase in TBN.
- Lower TBN, particularly a nitrogen index below 80% of predicted normal, was associated with a 4.1-fold increased risk of death within 12 months.
Conclusions:
- Nutritional status, as assessed by TBN, differs significantly between HD and CAPD patients.
- Total body nitrogen is a significant predictor of mortality in patients on maintenance dialysis.