Nutritional Requirements and Actual Dietary Intake of Continuous Ambulatory Peritoneal Dialysis Patients

Abstract

Objective

Nutritional status is related to morbidity and mortality in the continuous ambulatory peritoneal dialysis (CAPD) population. In the present study, we compared the dietary intake of CAPD patients with their requirements for calorie and protein nutrition and with the recommended intakes of potassium and phosphate.

Design

Patients were recruited from the CAPD clinic. Desirable body weight was derived from the height of the individual patients and the desirable body mass index (BMI) for adult Asians. The calorie requirement was calculated by multiplying desirable body weight by 30 kcal. The protein requirement was calculated by multiplying desirable body weight by 1.2 – 1.5, according to serum albumin level. The K requirement was set at 3500 mg daily, and the PO₄ requirement, at 1000 mg daily. The actual dietary intake of individual patients was estimated from dietary history by a computer software program.

Results

The study included 57 patients who had been on CAPD for 22.1 ± 23.5 months. Of the 57 patients, 8 patients (14.0%) were below the desirable BMI range, 20 (35.1%) were within the range, and 29 (50.9%) were above the range. By subjective global assessment (SGA), 45 patients (78.9%) were mildly-to-moderately malnourished, and 12 (21.1%) well nourished. Serum albumin was 32.1 ± 4.7 g/L. Patients met 98% ± 35.7% (range: 33% – 224%) of their nutritional requirement for calories and 92.1% ± 37.7% (range: 22% – 202%) of their nutritional requirement for protein. Only 23 patients (40.4%) reached the target for calorie intake, and only 22 (38.6%) reached the target for protein intake. Excess K intake was seen in 1 patient (1.8%), and excess PO₄ intake, in 6 patients (10.5%). Actual dietary intake was not related to BMI or SGA score.

Conclusion

Most CAPD patients had inadequate calorie and protein intakes. Calorie and protein intakes were not related to BMI and SGA scores. Compliance with recommended K and PO₄ intakes was good.