Differences in clinical and laboratory data of peritoneal dialysis patients selected according to body mass index.

The aim of the present study was to compare parameters of dietary intake, nutritional status, dialysis adequacy, and laboratory data between continuous ambulatory peritoneal dialysis (CAPD) patients having a normal body mass index (BMI) and those having an increased BMI. Two groups were selected: BMI = 20-25 (group I, n = 29) and BMI = 25-30 (group II, n = 19). No difference in age or peritoneal dialysis duration were observed between the study groups. Among parameters of dietary intake, only vitamin C ingestion was higher in group II than in group I. As compared with the patients in group I, the patients in group II showed significantly higher total body mass, lean body mass, fat body mass, and total body water. The Kt/V was lower in group II than in group I. In group II, values of serum iron concentration and transferrin saturation were both lower than those seen in group I. No differences were observed between the study groups for the other examined parameters. Those results show that overweight CAPD patients have higher anthropometric parameters and a lower Kt/V owing to a higher urea distribution volume. Disorders in iron parameters are more frequent in overweight patients. The observed differences do not influence duration of peritoneal dialysis treatment.

Differences in peritoneal equilibration test results in patients aged above or below 60 years.

Peritoneal permeability, evaluated using the peritoneal equilibration test (PET), indicates that, in an adult population not selected for age, an increase in the transport rate of small solutes usually occurs in the course of peritoneal dialysis (PD) treatment. We evaluated the dialysate-to-plasma ratio of urea (D/P urea), the D/P creatinine, the ratio of dialysate glucose at a designated dwell time to dialysate glucose at 0 dwell time (D/D0 glucose), and the mass transfer-area coefficients (KBDs) of those solutes in PETs performed in patients aged above or below 60 years who were matched for sex, PD duration, and outcome. The single-center, retrospective study was carried out in a peritoneal dialysis unit in a university hospital. Two groups of PD patients were chosen. Mean age of patients in group I (n = 21; 9 women, 12 men) was 67.7 +/- 4.5 years; PD duration was 20.1 +/- 12.1 months. In group II, the patients (n = 21; 9 women, 12 men) had a mean age of 42.8 +/- 9.1 years, and had been treated with PD for 20.7 +/- 12.1 months. A standard PET was performed according to Twardowski et al every 3 months from PD start to PD end. The first results, the mean results representing the entire PD course, and the last results were compared between groups. In addition, the first and the last results were compared within each group. No significant differences were seen between the groups in peritoneal transport in the first PET. In the last PET, the curves for D/P urea and D/P creatinine, and the KBD for urea, were significantly lower in the older patients than the curves obtained at PD start. In consequence, a tendency toward lower D/P ratios or KBDs for urea and creatinine in the last and mean PETs was observed in group I as compared with group II. No significant changes were seen in the peritoneal transfer of glucose in the course of PD or between groups. Older patients may show a reduction in peritoneal permeability from the vascular to the mesothelial side of the membrane in the course of PD treatment; peritoneal transport in the opposite direction remains unchanged during approximately 20 months from the start of PD treatment. The patients under 60 years of age maintain stable bi-directional permeability under a comparable PD duration.

[Serum zinc concentration with reference to other markers of continuous ambulatory peritoneal dialysis patients status]. / Stezenie cynku w surowicy w odniesieniu do innych wskazników stanu chorych leczonych ciagla ambulatoryjna dializa otrzewnowa.

The aim of our studies included measurement of serum Zn level in CAPD patients with the subsequent evaluation of relations between serum Zn and markers of nutrition, dietary intake, markers of acute phase reaction, CAPD adequacy, nitrogen balance as well as routine clinical and laboratory data. The study was performed in 81 patients treated with CAPD for up to 3 years (12 3-month study periods). Mean serum Zn concentration was 12.2 +/- 1.8 mumol/l and was decreased in 16% of patients. Positive correlation was shown between serum Zn level and prealbumin, iron, transferrin saturation, haemoglobin, mean corpuscular haemoglobin concentration and dialysis duration. Negative correlation was shown between serum Zn level and patients age as well as daily influent and effluent volumes, what means that patients in age over 65 years and those using daily inflow or outflow dialysate volume greater than 12.7 and 12.9 I, respectively, are at risk of Zn deficiency. Dietary Zn intake (9.9 +/- 2.5 mg/day) was in 96% of patients lower than that recommended for CAPD patients. Relation between Zn intake and ferritin, total cholesterol and vitamin E in serum as well as HDL-/total cholesterol ratio was shown. Our results indicate that approx. 16% of CAPD patients need Zn supplementation. Serum Zn level in CAPD patients shows a beneficial effect on serum markers of iron metabolism, blood morphology indices, serum lipid profile and increased serum vitamin E level.