Abstract: SA-PO699
Patient On Line (POL) Software as Useful Tool in Assessing Nutritional Status of Peritoneal Dialysis Patients
Session Information
- Peritoneal Dialysis - II
November 04, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Dialysis
- 608 Peritoneal Dialysis
Authors
- Suchowierska, Ewa, I Department of Nephrology and Transplantation with Dialysis Unit, Medical University of Bialystok, Poland, Bialystok, Poland
- Naumnik, Beata, Medical University of Bialystok, Bialystok, Poland
Background
Moderate to severe malnutrition is associated with increased risk of death in peritoneal dialysis (PD) patients. Serum albumin concentration below 3,8 g/dl is a biochemical surrogate for malnutrition. Protein loss into dialysate and urine contributes to malnutrition problems. The nPCR (normalized Protein Catabolic Rate), mentioned as protein equivalent of nitrogen appearance, is useful in assessing protein intake. Patient on Line (POL) software, calculating the adequacy parameters, is widely used to adjust therapy to patient’s needs. This method involves direct measurement of 24 hour dialysate and urea appearance rate to which a value for estimated dialysate and urine protein loss is added.
Methods
We compared classical measurements such as Kt/V, CCr and nPCR (by Randerson formula) with values calculated with POL software created by Fresenius Medical Care (Bad Homburg, Germany). 20 PD patients (mean age 49 +/-14.5 yrs) were included. Measurements were done at the same time using two methods (classical and POL). LTM (Lean Tissue Mass), % LTM, FAT and % FAT were assessed by Fresenius Body Composition Monitor. Total protein, albumin, calcium and phosphate levels as well as mean dialysate and urea protein loss were assessed by routine tests. SATISTICA 10.0 was used for data analysis.
Results
Kt/V was lower than Kt/V POL (p=0.0001), CCr was higher than CCr POL (p=0.0045) and nPCR was higher than nPCR POL (p=0.0001). We observed a strong positive correlations between total protein level and Kt/V POL (r=0.69, p<0.05), CCr (r=0.56, p<0.05), CCr POL (r=0.55, p<0.05) as well as between blood urea level and nPCR calculated classically (r=0.77, p<0.05) and with POL formula (r=0.69, p<0.05). Phosphatemia was negatively correlated with Kt/V (r=-0.51, p<0.05), Kt/V POL (r=-0.62, p<0.05), CCr (r=-0.61, p<0,05) and CCr POL (r=-0.65, p<0.05).
Conclusion
POL software seems to be a better tool in assessing PD patients’ nutritional status than Randerson formula, because it takes into account dialysate and urine protein loss. Kt/V POL, but not Kt/V values, positively correlated with total protein level. Phosphatemia and urea concentration were strong predictors of adequacy and nutritional parameters in PD patients.