Laboratory surrogates of nutritional status after administration of intraperitoneal amino acid-based solutions in ambulatory peritoneal dialysis patients
1995; Elsevier BV; Volume: 5; Issue: 3 Linguagem: Inglês
10.1016/1051-2276(95)90040-3
ISSN1532-8503
AutoresGlenn M. Chertow, J. Michael Lazarus, Maureen E Lyden, Daryl J. Caudry, Paul Nordberg, Edmund G. Lowrie,
Tópico(s)Health Systems, Economic Evaluations, Quality of Life
Resumo•п Objective: To determine whether the intraperitoneal administration of amino acid-based dialysate (intraperitoneal nutrition [IPN]) is associated with longitudinal trends in laboratory surrogates of nutritional status, such as serum albumin. •п Design: Case series. •п Setting: Free-standing outpatient dialysis clinics. •п Patients: One hundred eighty-three ambulatory peritoneal dialysis (PD) patients. •п Intervention: The initiation of IPN therapy between January 1993 and June 1994. •п Main outcome measures: Time trend in laboratory variables. •п Results: The mean duration of IPN therapy was 6.6 months (range, 2 to 19 months). The mean serum albumin concentration at baseline was 26.5 ± 4.9 g/L [2.65 ± 0.49 g/dL]. Serum albumin concentration (odds ratio = 0.48, 95% confidence interval [0.25, 0.92] per each gram per deciliter increase, P < .03) and body mass index (odds ratio = 1.09, 95% confidence interval [1.02, 1.16] per each kilogram per meter squared increase, P < .01) at baseline were associated with hospitalization or death during IPN therapy. There was a statistically significant increase in serum albumin concentration over time (0.5 g/L/mo [0.05 g/dL/mo], after adjusting for age, sex, bod ymass index, and the duration of prior PD, P < .0001). There were small changes in body weight and other laboratory variables that were neither statistically nor clinically significant. •п Conclusions: In an uncontrolled group of IPN recipients, reduced serum albumin concentration and obesity at baseline were predictive of subequent hospitalization or death. A statistically significant increase in serum albumin concentration was observed over time. These findings should encourage prospective, controlled assessment of IPN and other therapeutic strategies that might improve the nutritional status of ambulatory PD patients.
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