ENERGY-INTAKE IN PATIENTS ON CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS AND HEMODIALYSIS

Objectives. To compare patients on continuous ambulatory peritoneal di alysis (CAPD) with those on haemodialysis (HD) regarding food composit ion and energy intake. Design. Prospective food recording during 5 con secutive days. Setting. Nephrology section at a University hospital. S ubjects. Fifteen patients on CAPD and 15 patients on HD, matched for a ge, gender, duration of dialysis and body mass index (BMI). Main outco me measures. Percentage macronutrient energy composition, with and wit hout inclusion of transperitoneal glucose uptake. Daily energy intake, both total and from the different macronutrients. Results. The percen tage contribution of the dietary macronutrients to the energy intake w as about the same in the two dialysis groups, although the actual ener gy intake in CAPD patients was lower from all three macronutrients (P= 0.02-0.04). The mean intraperitoneal glucose load in CAPD patients was 159 g day(-1), which is approximately equivalent to 2700 kJ. Inclusio n of this additional energy (estimated uptake: 70% of the intraperiton eal energy load=19% of total energy intake) significantly increased th e carbohydrate fraction and decreased the protein and fat fractions (P <0.0001). Furthermore, this inclusion resulted in almost identical va lues for total energy intake in the two groups (approximate to 144 kJ kg(-1) day(-1)) and, in CAPD patients, a significantly higher actual e nergy contribution from carbohydrates (P=0.04). Conclusions, Transperi toneal energy intake more than compensates for the lower oral dietary energy intake seen in CAPD patients. Nevertheless, the level of total energy intake places both patient groups in the risk zone for developi ng malnutrition.