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Nutritional parameters in diabetic patients on CAPD
R Scanziani1, B Dozio, G Bonforte
1Renal Unit, Desio Hospital, Milan, Italy.
Summary
Diabetic patients on dialysis experience declining kidney function and protein loss over 24 months, leading to lower albumin levels. This study highlights nutritional challenges and potential causes for higher mortality in diabetic dialysis patients.
Area of Science:
- Nephrology
- Diabetology
- Nutritional Science
Background:
- Diabetic patients on dialysis face higher morbidity and mortality rates.
- Limited data exists on the nutritional parameters of diabetic patients experiencing high dropout rates during dialysis treatment.
Purpose of the Study:
- To compare nutritional parameters, dialytic dose, renal residual function, and peritoneal clearances between diabetic and non-diabetic patients undergoing continuous ambulatory peritoneal dialysis (CAPD) over 24 months.
Main Methods:
- A comparative study of 8 diabetic and 10 non-diabetic patients on CAPD, matched for age and weight.
- Nutritional parameters (BMI, PCRN, albumin, transferrin, cholesterol), Kt/V, RRF, and peritoneal clearances (Kdu, Kdcr) were measured at 1 and 24 months.
Main Results:
- Diabetic patients initially had higher Kt/V and residual renal function but also greater protein loss.
- After 24 months, diabetics showed significant decreases in albumin, PCRN, and Kt/V, with a non-significant reduction in RRF.
- BMI increased significantly in both groups, more so in diabetics, while transferrin and cholesterol remained stable.
Conclusions:
- Diabetic patients on CAPD experience a decline in renal and peritoneal clearances, reduced protein intake, and increased protein loss, contributing to lower albumin levels.
- These factors may explain the increased morbidity and mortality observed in diabetic patients undergoing dialysis.