1996 PERITONEAL-DIALYSIS CORE INDICATORS STUDY - REPORT ON NUTRITIONAL INDICATORS

Objective: The 1996 Peritoneal Dialysis Core Indicators Study illustra tes the conduct of peritoneal dialysis in the United States during 199 6. Design and Patient Population: The survey is a medical records audi t of 1317 randomly selected adult U.S.A. Medicare patients using perit oneal dialysis during 1996. Outcome Measures: Abstracted data included basic demographic characteristics, dialysis prescription, delivered d ialysis dose, residual renal function, serum albumin, hematocrit, anem ia management, and patient status. Results: The survey included 785 pa tients using continuous ambulatory peritoneal dialysis (CAPD) and 423 using automated peritoneal dialysis (APD) primarily in the form of con tinuous cycling peritoneal dialysis (CCPD). Except for the prescriptio n mechanics and a greater likelihood that African-Americans would use CAPD, the groups did not differ substantially from one another. Evalua tion of patient weight (W), body mass index (BMI), residual renal func tion, average serum albumin, protein equivalent of nitrogen appearance (nPNA), and dialysis efficiency as weekly fractional urea nitrogen re moval (wKt/V-urea) and weekly creatinine clearance (wCrCl) revealed a picture of reasonable dialysis delivery and marginal protein nutrition . Additionally, there was little evidence that ''dialysis efficiency,' ' over the range assessed, had a major influence on nutritional status . Despite a tendency toward obesity (body weight = 76.6 +/- 20.0 kg an d BMI = 27 +/- 7), 47% of patients had an average serum albumin below ''normal'' (3.5 g/dL by bromcresol green) and 70% had a nPNA below 1.0 g/kg/day. Conclusions: Peritoneal dialysis patients appear to have ma rginal protein reserves despite surfeit energy stores.