Nutrient intake during peritoneal dialysis at the Prince of Wales Hospital in Hong Kong.

ABSTRACT

BACKGROUND: Individuals undergoing peritoneal dialysis are at increased risk of developing cardiac disease and malnutrition. STUDY DESIGN: A cross-sectional survey. SETTINGS AND PARTICIPANTS: 249 Chinese continuous ambulatory peritoneal dialysis (CAPD) patients were recruited from the Prince of Wales Hospital in Hong Kong. Another 249 age- and sex-matched controls were recruited from an archive of 1,010 individuals with known food frequency questionnaire (FFQ) data. OBJECTIVE: To compare the dietary intake pattern of CAPD patients with controls and evaluate its association with background cardiac disease. OUTCOMES AND MEASUREMENTS Intake of different nutrients was estimated by using a 7-day FFQ. RESULTS: Intake of all nutrients was lower in CAPD patients than controls, with resulting lower overall energy intake. Nutrient intake was decreased further in CAPD patients with background cardiac disease, which corresponded to worse nutritional status. Controlling for age, male sex, body weight, diabetes mellitus, dialysis therapy duration, residual renal function, peritoneal dialysis urea clearance, and Charlson Comorbidity Index score, background cardiac disease was associated independently with less intake of energy and most macronutrients and micronutrients. However, the association between background cardiac disease and energy and most nutrient intake was decreased or even lost when additional adjustment was made for C-reactive protein and serum albumin levels. LIMITATIONS: An FFQ is limited in that nutrient quantitation is not exact and may be underestimated as a result of underreporting by patients. CAPD patients were compared with a control group without cardiovascular disease ascertainment that did not include subjects with diabetes. CONCLUSIONS: Chinese CAPD patients had significantly lower nutrient intake than age- and sex-matched controls. The association between cardiac disease and lower dietary macronutrient and micronutrient intake in CAPD patients was mediated in part through systemic inflammation, which also was associated with more malnutrition. More attention should be focused on improving the intake pattern of Chinese CAPD patients.