Impact of peritoneal dialysis modality on nutritional and biochemical parameters

Several lines of evidence suggest that continuous ambulatory peritoneal dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD) may differ in glucose, amino acid, and protein mass transfer. Thus, depending on modality, variances in protein and caloric balance could affect nutritional parameters. We prospectively followed 58 patients on CAPD (n = 36) or CCPD (n = 22) for 21 months (age: 54 +/- 14 years; weight: 76 +/- 16 kg; body mass index: 25.8 +/- 5.1 kg/m2). Twenty-four-hour dialysate effluent (Kpt/V) and normalized protein catabolic rate values were comparable in both CAPD and CCPD patients (0.23 +/- 0.05 vs 0.20 +/- 0.05 and 0.93 +/- 0.23 vs 0.87 +/- 0.21 g/kg/day, respectively). At the last trimester, CAPD patients had greater body weight and body mass index increases than those on CCPD (1.6 +/- 1.1 vs 0.3 +/- 1.1 kg and 0.53 +/- 0.42 vs 0.06 +/- 0.35 kg/m2, respectively), which did not reach statistical significance. No differences were noted in serum protein, albumin, or cholesterol levels (6.5 +/- 0.1 vs 6.5 +/- 0.2 g/dL; 3.5 +/- 0.1 vs 3.7 +/- 0.1 g/dL; and 211 +/- 10 vs 209 +/- 10 mg/dL for CAPD and CCPD, respectively). In summary, this study demonstrates that CAPD and CCPD, when delivered in equal amounts, result in similar weight gains and maintain comparable biochemical nutritional parameters.