Effects of nutrition on residual renal functions during peritoneal dialysis

Purpose:The aim of the present study was to demonstrate the effect of nutritional management on residual renal function; and the efficacy of dialysis by providing adequate calorie supplements to Continuous Ambulatory Peritoneal Dialysis (CAPD) patients. Materials and methods: Twelve CAPD patients followed in the Diyarbakır Children’s Hospital between September 2014 and March 2015 were enrolled in the study. Nine subjects using the same type of CAPD fluid were provided with oral calorie supplements Recommended Dietary Allowance with the same type of enteral nutrition products due to inadequate calorie and protein intake. Anthropometric measurements were evaluated at baseline, month 3, and month 6 by calculating nutritional parameters, biochemical parameters residual renal functions, and calculations of urea clearance (Kt/V) before the nutrition support. Results: Statistically significant difference was detected in weight (p=0.01), Kt/V (p=0.03), and residual renal function (p=0.01) starting from the 6th month after providing nutrition support to the patients. Also CaxP value improved during month 3 (p=0.01). Conclusion: We believe that providing adequate calorie supplements to peritoneal dialysis patients can reduce supportive care needs, allow better preservation of residual renal function, and improve the efficacy of dialysis.

Periton diyalizi hastalarında beslenmenin rezidüel böbrek fonksiyonları üzerine etkileri

Amaç:Bu çalışmanın amacı SAPD (Sürekli Ayaktan Periton Diyalizi) hastalarında yeterli kalori takviyeleri sağlayarak rezidüel renal fonksiyonlar üzerine etkinliğini göstermeyi amaçladık. Gereç ve yöntem: 2014 Eylül ve 2015 Mart tarihleri arasında xxxxxx Hastanesinde takip edilen 12 SAPD hastası çalışmaya alındı. Yetersiz protein ve kalori alımı tespit edilen dokuz hastada aynı tip SAPD sıvısı kullanılarak kalorili takviyeleri RDA’ya göre aynı tip enteral beslenme ürünü kullanıldı. Beslenme parametreleri başlangıçta, 3. ve 6. ayda vücut oran ölçümleri hesaplanarak değerlendirildi. Biyokimyasal parametreleri rezidüel renal fonksiyon ve total üre klirensi (Kt/V) hesaplamaları yapıldı. Bulgular: Beslenme desteği sağladıktan 6 aydan itibaren hastalara ağırlığı (p=0.01) ve rezidüel renal fonksiyonu (p=0.01) ve Kt/V(p=0.03) istatistiksel olarak anlamlı bir fark saptandı. Ayrıca 3. ayda CaxP değerinde belirgin iyileşme görüldü (p=0.01). Sonuç: Periton diyaliz hastaları için yeterli kalori takviyesi sağlandığında destek tedavi ihtiyacını azaltdığı, rezidüel renal fonksiyonları daha iyi koruma sağladığı ve periton diyaliz etkinliğini artırdığına inanıyoruz.

Kaynakça

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Cano NJ, Aparicio M, Brunori G, et al. ESPEN guidelines on parenteral nutrition: adult renal failure. Clin Nutr 2009;28:401-414

Wang AY, Wang M, Woo J, et al. A novel association between residual renal function and left ventricular hypertrophy in peritoneal dialysis patients. Kidney Int 2002;62:639-647.

Young GA, Kopple JD, Lindholm B, et al. Nutritional assessment of continuous ambulatory peritoneal dialysis patients: an international study. Am J Kidney Dis 1991;17:462-471.

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Szeto CC, Wong T YH, Leung CB, et al. Importance of dialysis adequacy in mortality and morbidity of Chinese CAPD patients. Kidney Int 2000;58:400-407.

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KDOQI Work Group. KDOQI Clinical Practice Guideline for nutrition in children with CKD: 2008 update. Executive summary. Am J Kidney Dis. 2009;53:11-104.

Coleman JE, Watson AR, Rance CH, Moore E. Gastrostomy buttons for nutritional support on chronic dialysis. Nephrol Dial Transplant. 1998;13:2041-2046.

Choi HY, Lee JE, Han SH, et al. Association of inflammation and protein-energy wasting with endothelial dysfunction in peritoneal dialysis patients. Nephrol Dial Transplant. 2010;25:1266-1271.

Kopple JD, Blumenkrantz MJ, Jones MR, Moran JK, Coburn JW. Plasma amino acid levels and amino acid losses during continuous ambulatory peritoneal dialysis. Am J Clin Nutr. 1982;36:395-402.

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Kaynak Göster

  • ISSN: 1309-9833
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2008

2.5b409

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