CROSS-SECTIONAL ASSESSMENT OF NUTRITIONAL AND IMMUNE STATUS IN RENAL PATIENTS UNDERGOING CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS

Malnutrition prevalence and immunocompetence were assessed in uremic p atients undergoing continuous ambulatory peritoneal dialysis (CAPD). F orty-two males and twenty-four females with kidney disease treated wit h CAPD were distributed into three groups according to the length of t ime they had been undergoing dialysis. Group 0 included patients begin ning dialysis; group 1, patients undergoing CAPD for < 30 mo, and grou p 2, patients undergoing CAPD for > 30 mo. Body weight and body mass i ndex were greater in patients who had been undergoing CAPD for longer periods of time (approximate to 11% in males and 14% in females), whic h was accompanied by higher fat stores and muscle mass when assessed t hrough triceps skinfold thickness and arm muscle measurements. These d ifferences were more apparent in females than in males. Immunoglobulin M values were lower in patients in groups 1 and 2 than in group 0, wh ereas retinol binding protein, fibronectin, and C4 were higher. Estima ted protein intake was higher in predialysis patients (1.31 g.d(-1).kg (-1)) than in the other groups (approximate to 0.95 g.d(-1).kg(-1)). T he percentage of B cells decreased with time an dialysis. Although no changes in total or helper T cells were found, a significant rise was noted for the T cell subpopulation with assumed suppressor and cytotox ic activities and for natural killer cells in those patients undergoin g longer periods of CAPD treatment. Alterations in immune cell numbers in immunoglobulins and complement proteins might be responsible for i mmunologic disturbances and infectious processes occurring in patients with chronic renal failure and undergoing CAPD.