Multicenter cross-sectional study for dialysis dose and physician's subjective judgment in Japanese peritoneal dialysis patients. Group for the Water and Electrocyte Balance Study in CAPD
Kumano, K.; Kawaguchi, Y.
American Journal of Kidney Diseases the Official Journal of the National Kidney Foundation 35(3): 515-525
2000
ISSN/ISBN: 0272-6386 PMID: 10692279 Document Number: 518454
The purpose of this study was to investigate the state of dialysis and nutrition among Japanese peritoneal dialysis (PD) patients. Two hundred thirty-nine Japanese PD patients from 21 centers, 79 female and 160 male, were evaluated to determine their status of dialysis and nutrition. Mean age of the patients was 50 years; mean duration on PD, 4.2 years; mean body weight, 58 kg; and body surface area (BSA), 1.61 m(2). Sixty-three percent of the patients had no residual renal function. Mean daily delivered volume was 6.9 L for female continuous ambulatory peritoneal dialysis (CAPD), 8.1 L for male CAPD, 10.5 L for female automated peritoneal dialysis (APD), and 10.7 L for male APD. Total (dialysis and kidney) mean weekly values for creatinine clearance (Ccr), Kt/V, and beta2 microglobulin (beta2MG) clearance were 56 L/1.75 m(2), 1.80, and 11 L/1.73 m(2), respectively. Fifty percent of the patients who had no residual renal function (RRF) and 17% of the patients with RRF did not achieve 50 L/wk/1.73 m(2) of Ccr. With regard to nutritional parameters, mean values for plasma total protein, serum albumin, and normalized protein catabolic rate (nPCR) were 6.5 g/dL, 3.6 g/dL, and 0.97 g/kg BW/d. Mean daily protein loss was 5.8 g. Although a significant number of patients did not achieve 50 or 60 L/wk/1.73 m(2) of Ccr, the physicians determined that 72% of the patients received adequate dialysis and 71% were well nourished according to clinical and laboratory features. In conclusion, the daily prescribed volume and the delivered dialysis dose were lower than expected. The discrepancy between the actual delivered dialysis dose and the physicians' evaluation should be explored in the future.