Korean Journal of Nephrology 2000;19(3):483-491.

원저 : 5년이상 장기 지속적 외래 복막투석 환자의 영양상태와 투석 적절도 (Nutrition and Dialysis Adequacy of Korean Patients on Long-term CAPD)

김용림(Yong Lim Kim),조동규(Dong Kyu Cho),김성호(Sung Ho Kim),조영준(Young Jun Cho),신용봉(Yong Bong Shin)

Abstract

CAPD may have many negative impacts on nutritional status. Protein and caloric malnutrition are highly prevalent in chronic CAPD patients. In order to evaluate the relationship between nutritional and dialysis adequacy of long-term CAPD patients, twenty patients treated for aver 5 years on CAPD, with a mean age of 50.5±12.2 years and dialysis duration of 82.6±19.5 months(range 60-116) were studied. Four-teen of the twenty patients(70%) had no residual renal function(RRF). In these twenty patients the mean weekly Kt/Vurea and Ccr were 1.85±0.24 and 58.110.8L/week/1.73m²with the median body surface area(BSA) of 1.61m². Female(n=7) patients had lower BSA(1A7 vs 1.69m²), TBW(27.7 vs 35.6L), and higher serum albu-min(4.01 vs 3.41g/dL), weekly Kt/Vurea(2.02 vs 1.76) than male(n=13) patients. Six patients had nPCR0.9 and nPCR was negatively correlated with age(r= -0.53, p<0.05), BSA(r=-0.54, p<0.05) and positively correlated with serum albumin(r=0.53, p<0.05). Serum albumin was not changed during 5 years of CAPD. Fourteen patients were well nourished and six patients were mild to moderately malnourished on SGA score. Fourteen of the twenty patients had nor- mal serum albumin(≥3.5g/dL) and 6 had hypoalbu- minemia(<3.5g/dL). Serum albumin was positively correlated with nPCR(r=0.53, p<0.05) and negatively with BSA(r=-0.6S, p<0.001) and total body water (TBW)(r=-0.69, p<0.001). Hypoalbuminemia patients had high peritoneal membrane transport characteristics(24h D/Pcr 0.84 vs 0.74, p<0.05). Four patients had weekly Kt/Vurea>2.0 and Kt/Vurea was nega-tively correlated with BSA(r=-0.61, p<0.001). In conclusion, for Korean patients on long-term CAPD, small body size is the key for adequate dialysis and nutrition. Low serum albumin levels may be related with high peritoneal transport.