Analyses of protein losses via dialysate and its influencing factors in peritoneal dialysis patients
1.School of Environmental Science and Public Health, Wenzhou Medical University, Wenzhou, 325035; 2.Department of Nutrition and Food Hygiene, School of Public Health, Huazhong University of Science and Technology, Wuhan, 430030
SUN Fangyun1,RAN Gai1,XIANG Siyun2, et al. Analyses of protein losses via dialysate and its influencing factors in peritoneal dialysis patients[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2015, 45(1): 18-.
Abstract：Objective: To explore the daily protein losses via dialysate and its influencing factors in continuous ambulatory peritoneal dialysis (CAPD) patients, to provide theoretical basis for clinical nutrition support. Methods: Seventy two non-diabetic nephropathy patients with uremia and treatment with CAPD for longer than 3 months were recruited during December 2012 to October 2013 from a general hospital. General information, laboratory testing data, and global assessment of nutritional information of the patients were collected. Dietary surveys were conducted for 7 consecutive days to obtain protein and energy intake in patients. According to the amount of protein losses after dialysis, patients were divided into two groups, low protein losses group (<5 g•d-1) and high protein losses group (≥5 g•d-1). Relevant indicators were compared between two groups, logistic regression analysis was applied to analyze the factors which affect the level of protein loss in patients. Results: The median of protein losses in CAPD dialysis patients was 5.0 (range: 1.7-21.1) g•d-1, which was about 13.0 percent of total daily protein intake (95%CI: 10.8%-15.2%). Patients in high protein losses group showed a lower serum albumin level (P<0.05 ), higher serum creatinine, and higher urea nitrogen levels (P<0.05). There was no statistically significant difference between two groups in prealbumin, hemoglobin, transferrin, SGA score, nPNA and anthropometric measures such as BMI, MAMC, and MAC (P>0.05). Long dialysis duration, high peritoneal transport, high blood urea nitrogen, and male were risk factors of high protein losses by dialysate. Conclusion: CAPD patients may lose substantial amount of protein by dialysis solution, the loss amount is related with duration of dialysis, peritoneal transport characteristics, blood urea nitrogen level, and gender. The protein losses over 5 g•d-1 by dialysate may lead to lower serum albumin level. In terms of patients whose protein loss amounts were higher than 5 g•d-1 by dialysate, it is necessary to improve their current DPI levels (0.84 ± 0.25) g•kg-1•d-1).
