CROSS-SECTIONAL ASSESSMENT OF WEEKLY UREA AND CREATININE CLEARANCES AND INDEXES OF NUTRITION IN CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS PATIENTS

Objective: To perform a cross sectional analysis in 71 patients on con tinuous ambulatory peritoneal dialysis (CAPD) to identify significant correlations of weekly small solute clearances and indices of nutritio nal status with each other and with patient demographics and other com monly monitored clinical and laboratory parameters. Design: This was a retrospective, cross sectional analysis in 71 patients on CAPD from l ess than 1 to 105 patient-months (average, 20 months). Setting: An out patient CAPD program. Patients: All patients on CAPD in our program at the time of the study willing to undergo the clearance and nutritiona l status measurements. Interventions: No interventions other than the monitoring of their status. Main Outcome Measures: Weekly small solute clearances, dietary protein intake, serum albumin, lean body mass, ne t protein catabolic rate, and urinary and dialysate nitrogen. Results: Weekly Kt/V urea (weekly urea clearance normalized to total body wate r) of at least 1.7 and weekly total creatinine clearances (liter/week/ 1.7 m2) of at least 50 are associated with net protein catabolic rates (PCR) greater than 0.9 g/kg of normalized body weight in average CAPD patients. Kt/V urea and net PCR correlate significantly with serum al bumin. High transporters identified by the peritoneal equilibration te st have greater albumin losses and lower serum albumin concentrations. Estimates of lean body mass correlate significantly with serum albumi n and net PCR; lean body mass correlates significantly and inversely w ith age. Conclusions: Greater small solute clearances are associated w ith better nutritional status.