Nutritional evaluation in relation to adequacy of peritoneal dialysis

Abstract

Background
Dialysis adequacy and nutritional status are pivotal for the prognosis of patients undergoing peritoneal dialysis (PD).
Objective
This study investigated the predictive factors of dialysis adequacy, with a special focus on the normalized protein catabolic rate (nPCR), a promising marker of protein intake and nutritional status.
Methods
This is a retrospective, descriptive and analytical study carried out between June 2006 and January 2024; it included 151 patients on PD. Patients were categorized into two groups based on total Kt/V: Group A (inadequate dialysis: Kt/V < 1.7) and Group B (adequate dialysis: Kt/V ≥ 1.7). Nutritional and biochemical markers were analyzed, including body mass index (BMI), albumin, hemoglobin, ferritin, triglycerides, and nPCR. Statistical comparisons used t-test, Welch’s test, ANOVA, chi-square, or binomial tests; P < 0.05 was considered significant.
Results
Dialysis adequacy was significantly associated with higher residual kidney function (RKF), estimated glomerular filtration rate (eGFR), and nPCR levels, while it was negatively correlated with serum creatinine, urea, uric acid, and BMI. An nPCR < 0.8 g/kg/day and BMI ≥ 25 kg/m² were identified as independent predictors of inadequate dialysis. Polycystic kidney disease was also associated with dialysis inadequacy.
Conclusions
Inadequate dialysis was significantly associated with poor nutritional indicators, particularly low nPCR and overweight. nPCR appeared to be a reliable marker for predicting dialysis adequacy. A multidimensional strategy emphasizing nutritional monitoring,