1997 Peritoneal dialysis-core indicators study: Dialysis adequacy and nutritional indicators report

The 1997 Peritoneal Dialysis-Core Indicators Study: Dialysis Adequacy and N utritional indicators Report documents the current status of peritoneal dia lysis within the United States. A national random sample of adult peritonea l dialysis (PD) patients participating in the United States End Stage Renal Disease (ESRD) program was surveyed. PD subjects were large, with a mean b ody weight of 76 +/- 18.9 kg (mean +/- 1 SD) and a body mass index (BMI) of 27 +/- 6.4. The dialysis prescriptions documented achieved a mean weekly K t/V-urea (wKt/V) and weekly creatinine clearance (wCrCl) of 2.45 +/- 2.29 a nd 65.5 +/- 35.2 L/wk/1.73m2, respectively The serum albumin of these patie nts was 3.5 +/- 0.48 g/dL, their normalized protein equivalent of nitrogen appearance (nPNA) 1.0 +/- 0.63 g/kg/d, and their normalized creatinine appe arance rate (nCAR) 14 +/- 6.0 mg/kg/d. Serum albumin correlated meagerly bu t in a positive fashion with BMI, nPNA, and nCAR, and negatively with wCrCl , Among adult US PD patients, serum albumin values appear to correlate poor ly with alternative measures of nutritional status and are inversely relate d to the intensity of renal replacement therapy. The presumptive dietary pr otein intake (nPNA) and creatinine appearance rate (nCAR) derived for PD pa tients do correlate in a positive fashion with dialysis delivery, at least up to a wCrCl of 60 to 80 L/wk/1.73 m(2) and wKt/V = 2.1, but their values suggest that 30% to 50% of PD patients have marginal nutritional status. (C ) 1999 by tbe National Kidney Foundation, Inc.