We studied the effect of Intraperitoneal Infusion of various volumes and concentrations of dextrose (D) and amino acid (AA) solutions, In a variety of peritoneal dialysis schedules on food Intake and biochemical profile in normal and uremic rabbits.
Following omentectomy, a peritoneal catheter was implanted. Animals had free access to food, and consumption was measured daily by weight of the remaining food in the cage.
We studied the effect of volume (30-50-100 mL/kg), dextrose concentration (0.5-1.5-2.5-4.25-6.6 g/dL) and AA (Travasol based) (2% in Dianeal or glucose-free solution).
Dialysis schedules Included once/day, twice/day, or four-daily exchanges similar to CAPD.
The durations of the exchanges were 4–6 weeks and in certain groups, amino acid exchanges for a week alternated with dextrose exchanges.
Our results Indicate the following: omentectomy and catheter implantation significantly decrease food Intake. There is a significant decrease In food Intake after initiation of dialysis that returns to baseline after 2–4 weeks while dialysis continues. Higher volumes (100 mL/kg) decrease food Intake significantly, especially with hypertonic solution of either D or AA. There was no difference in food Intake between D and AA Infusion In any amount of infused volumes.
Amino acids do not seem to have a suppressing effect on appetite. However, large volumes and hypertonicity reduce food Intake.
BlumenkrantzM.J., SaluskyI.B., SchmidtR.W.Managing the nutritional concerns of the patient undergoing peritoneal dialysis. In: NolphK.D., ed. Peritoneal dialysis.Boston: Martinus Nijhoff, 1985: 345–401.
5.
KhannaR., OreopoulosD.G.Complications of peritoneal dialysis other than peritonitis. In: NolphK.D., ed. Peritoneal dialysis.Boston: Martinus Nijhoff, 1985: 441–524.
6.
GutmanR.A., BlumenkrantzM.J., ChanY.K.Controlled comparison of hemodialysis and peritoneal dialysis: Veterans Administration multicenter study.Kidney Int1984; 26: 459–70.
7.
KurtzS.B., WongV.H., AndersonC.F., VogelJ.P., McCarthyJ.T., MitchellJ.C.Continuous ambulatory peritoneal dialysis. Three years’ experience at the Mayo Clinic.Mayo Clin Proc1983; 58: 633–9.
8.
ThomsonN.M., AtkinsR.C., HumphreyT.J., AgarJ.M., ScottD.E.Continuous ambulatory peritoneal dialysis (CAPD): An established treatment for end-stage renal failure.Aust NZ J Med1983; 13: 489–96.
9.
BakerJ.P., DetskyA.S., WessonD.E.Nutritional assessment. A comparis on of clinical judgement and objective measurements.N Engl J Med1982; 306: 969–72.
10.
DetskyA.S., McLaughlinJ.R., BakerJ.P.What is subjective global assessment of nutritional status?J Parent Ent Nutr1987; 11: 8–13.
11.
FentonS.S.A., JohnstonN., DelmoreT.Nutritional assessment of continuous ambulatory peritoneal dialysis.Trans Am Soc Artiflntern Organs1987; 33: 650–3.
12.
DombrosN.V., OreopoulosD.G.Nutritional aspects of patients on CAPD. In: La GrecaG., ChiaramonteS., FabrisA., FerianiM., RoncoC., eds. Peritoneal dialysis.Milano: Wichtig Editore, 1988: 113–8.
13.
OreopoulosD.G., MarlissE., AndersonG.H.Nutritional aspects of CAPD and the potential use of amino acid-containing dialysis solutions.Perit Dial Bull1983; 3: 10–5.
14.
Van BaeyerH., GahlG.M., RiedingerH.Adaptation of CAPD patients to the continuous peritoneal energy uptake.Kidney Int1983; 23: 29–34.
15.
GahlG.M., Von BaeyerH., RiedingerH.Caloric intake and nitrogen balance in patients undergoing CAPD. In: MoncriefJ.W., PopovichR.P., ed. CAPD update.New York: Masson, 1981: 87–93.
16.
WallsJ., BennettS.E.Maintaining nutrition in CAPD patients.Contrib Nephrol1990; 85: 79–83.
17.
GrodsteinG.P., BlumenkrantzM.J., KoppleJ.D.Nutritional and metabolic response to catabolic stress in uremia.Am J Clin Nutr1980; 33: 1411–6.
18.
YoungG.A., KoppleJ.D., LindholmB.Nutritional assessment of continuous ambulatory peritoneal dialysis patients: An international study.Am J Kidney Dis1991; 17: 462–71.
19.
DombrosN.V., ProtisK., TongM.Six-month overnight intraperitoneal amino-acid infusion in continuous ambulatory peritoneal dialysis (CAPD) patients no effect on nutritional status.Perit Dial Int1990; 10: 79–84.
20.
SchilingH., WuG., PetitJ.Effects of prolonged CAPD with amino acid-containing solutions in three patients. In: KhannaR., NolphK.D., ProwantB., TwardowskiZ.J., OreopoulosD.G., eds. Advances in continuous ambulatory peritoneal dialysis.Toronto: Peritoneal Dialysis Bulletin, 1985: 49–55.
21.
SchillingH., WuG., PetitJ.Use of amino acid-containing solutions in continuous peritoneal dialysis patients after peritonitis: Results of a prospective controlled trial.Proc Eur Dial Transplant Assoc Eur Ren Assoc1985; 22: 421–5.
22.
BrunoM., BagnisC., MarangellaM., RoveraL., CantaluppiA., LinariF.CAPD with an amino acid dialysis solution: A long-term, cross-over study.Kidney Int1989; 35: 1189–94.
23.
BiggsL.P.Acute appetite perception, food preference and taste acuity in CAPD patients dialyzed with a dextrose solution or an amino acid mixture in healthy controls (Thesis).Toronto: University of Toronto, 1990.
24.
YoungG.A., DibbleJ.B., HobsonS.M.The use of amino acid-based CAPD fluid over 12 weeks.Nephrol Dial Transplant1989; 4: 285–92.
25.
OrenA., WuG., AndersonG.H.Effective use of amino acid dialysate over four weeks in CAPD patients.Perit Dial Bull1983; 3: 66–73.
26.
GotloibL., CrasswellerP., RodellaH.Experimental model for studies of continuous ambulatory peritoneal dialysis in uremic rabbits.Nephron1982; 31: 254–9.
27.
SnedecorG.W., CochranW.G.Statistical methods.6th ed.Ames: The Iowa State University Press, 1967: 120–34.
28.
ShaperaM.R., MoelD.I., KamathS.K., OlsonR., Beau champG.K.Taste perception of children with chronic renal failure.J Am Diet Assoc1986; 86: 1359–65.
29.
BurgeJ.C., SchemmelR.A., ParkH.S., GreeneJ.A.Taste acuity and zinc status in chronic renal disease.J Am Diet Assoc1984; 84: 1203–9.
30.
Anonymous.Decreased taste acuity in chronic renal patients.Nutr Rev1981; 39: 207–10.
31.
Clinical measurement of taste and smell.New York: Macmillan, 1986: 111, 132–271.
32.
LaouariD., KleinknechtC., BurtinM., DoduC.Growth and appetite in chronic renal failure.Contrib Nephrol1988; 60: 192–206.
33.
LindholmB., BergstromJ.Nutritional management of patients undergoing peritoneal dialysis. In: MaherJ.F., WinchesterJ.F., eds. Frontiers in peritoneal dialysis.New York: Field, Rich and Associates, 1986: 230–60.
34.
FlynnM.A.Nutritional problems in CAPD.Perit Dial Bull1984; 4(Suppl 1): 142–6.
35.
KoppleJ.D.Nutritional requirements with CAPD. In: MaherJ.F., WinchesterJ.F., eds. Frontiers in peritoneal dialysis.New York: Field, Rich and Associates, 1986: 389–99.
36.
SchillingH., WuG., PetitJ.Nutritional status of patients on long-term CAPD.Perit Dial Bull1985; 5: 12–8.
37.
LindholmB., BergstromJ.Metabolic effects of peritoneal dialysis. In: La GrecaG., ChiaramonteS., FabrisA., FerianiM., RoncoC., eds. Peritoneal dialysis.Milano: Wichtig Editore, 1985: 111–8.
38.
ScarpioniL., BallochiS., PoisettiP.Long-term plasma protein status as an index of nutrition. In: La GrecaG., ChiaramonteS., FabrisA., FerianiM., RoncoC., eds. Peritoneal dialysis.Milano: Wichtig Editore, 1985: 241–4.
39.
NovinD., O'FarrellL., Acevedo-CruzA., GeiselmanP.J.The metabolic bases for “paradoxical” and normal feeding.Brain Res Bull1991; 27: 435–8.
40.
ManowitzP., Menna-PerperM., MuellerS., RochfordJ., SwartzburgM.Effect of insulin on human plasma tryptophan and non-esterified fatty acids.Proceedings of the Society for Experimental Biology and Medicine1977; 156: 402–5.
41.
TizianelloA., DeferrariG., GaribottoG., RobaudoC., CanepaA., PasseroneG.Is amino acid imbalance harmful to patients in chronic renal failure?Kidney Int1985; 28(Suppl 17): S79–83.
42.
MorleyJ.E., LevineA.S.The central control of appetite.Lancet1983; 1: 398–401.
AlvestrandA., FurstP., BergstromJ.Plasma and muscle free amino acids in uremia: Influence of nutrition with amino acids.Clin Nephrol1982; 18: 297–305.
47.
HrbotickyN., LeiterL.A., AndersonG.H.Effects of L-trytophan on short-term food intakes in lean men.Nutr Res1985; 5: 595–607.
48.
MustenB., PeaceD., AndersonG.H.Food intake regulation in the weanling rat: Self-selection of protein and energy.J Nutr1974; 104: 563–72.
49.
PengY., MelizaL., VavichM.G., KemmererA.R.Effects of amino acid imbalance and protein content of diets on food intake and preference of young, adult, and diabetic rats.J Nutr1975; 105: 1395–404.
50.
PengY., EvensonJ.K.Food preference and protein in take of normal and diabetic rats fed diets varying in protein quality and quantity.J Nutr1979; 109: 1952–61.
51.
Hepron-GreenwoodC.E., AndersonG.H.An overview of the mechanisms by which diet affects brain function.Food Tech1988; 40: 132–8.
52.
AndersonG.H., LiE.T.S.Protein and amino acids in the regulation of quantitative and qualitative aspects of food intake.Int J Obes1987; 11(Suppl 3): 97–108.
53.
MoncriefJ.W., Mullins-BlacksonC.V., PopovichR.P.Continuous ambulatory peritoneal dialysis: Principles, history and current statistics. In: MaekawaM., NolphK.D., KishimotoT., MoncriefJ.W., eds. Machine-free dialysis for patient convenience: The Fourth ISAO Official Sat ellite Symposium on CAPD.Cleveland: ISAO Press, 1984: 3–6.
54.
NunnJ.F., SharerN.M., BoltiglieriT., RossiterJ.Effect of short-term administration of nitrous oxide on plasma concentrations of methionine, tryptophan, phenylalanine and S-adenosyl methionine in man.Br J Anaesth1986; 58: 1–10.
55.
WernermanJ., VinnarsE.The effect of trauma and surgery on interorgan fluxes of amino acids in man.Clin Sci1987; 73: 129–33.
56.
MuscW.M.Appetite response and food intake, nitrogen balance and mood in patients with end-stage renal disease: amino acid vs. dextrose dialysate (Thesis).Toronto: University of Toronto, 1992.
