CROSS-SECTIONAL COMPARISON OF MALNUTRITION IN CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS AND HEMODIALYSIS-PATIENTS

Although malnutrition is not uncommon in continuous ambulatory periton eal dialysis (CARD) and maintenance hemodialysis (MHD) patients, there has never been a large-scale comparison study of nutritional status w ith these two dialysis modalities. We therefore assessed protein-calor ie nutrition in 224 CAPD patients and 263 MHD patients who were treate d in eight centers in Italy. The CAPD patients were slightly older tha n the MHD patients (60.2 +/- 14.2 years v 56.3 +/- 15.1 years; P < 0.0 1), had undergone dialysis for less time (2.32 +/- 2.10 years v 3.66 /- 2.66 years; P < 0.0001), and had higher residual renal function (1. 83 +/- 2.29 mL/min v 0.27 +/- 0.91 mL/min; P < 0.0001), Protein nitrog en appearance was 60.5 +/- 16.6 g/d and 61.9 +/- 16.5 g/d in the CAPD and MHD patients, respectively. In CAPD versus MHD patients, serum tot al protein and albumin tended to be lower; serum transferrin and mid-a rm muscle circumference were similar; and relative body weight, skinfo ld thickness, and estimated percent body fat tended to be greater. The se greater values in CAPD patients were particularly evident in those who were 65 years of age or older. Serum glucose, total cholesterol, a nd triglycerides also were greater in CAPD patients. The subjective gl obal nutritional assessment indicated a significantly greater proporti on of malnourished CAPD patients than MHD patients (42.3% v 30.8%). Th e greater prevalence of malnutrition in CAPD patients diminished with age. Maintenance hemodialysis patients older than 76 years were more l ikely to be malnourished than CAPD patients. In patients less than 65 years of age, protein-calorie malnutrition was more likely to be prese nt in CAPD patients than in MHD patients. (C) 1995 by the National Kid ney Foundation, Inc.