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Abstract: PO1273

Differences in Protein Energy Wasting Indicators by Peritoneal Transport Type: A Cross-Sectional Study with Automated Peritoneal Dialysis Patients

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Leal, Gabriela, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Ciudad de Mexico, Mexico
  • Vasquez jiménez, Enzo Christopher, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Ciudad de Mexico, Mexico
  • Osuna Padilla, Ivan Armando, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico Ciity, Mexico
  • Moguel, Bernardo, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Ciudad de Mexico, Mexico
  • Cano Escobar, Karla Bernice, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Ciudad de Mexico, Mexico
Background

In chronic kidney disease (CKD) population protein energy wasting syndrome (PEW) is a prevalent problem with a multifactorial etiology (uremia, low energy and protein intake, basal energy expenditure increased, inflammation, metabolic acidosis, nutrient loss during renal replacement therapy (RRT). In peritoneal dialysis, patients with high peritoneal transport tend to have enhanced clearance of small solutes and shows low ultrafiltration capacity and higher inflammatory state, that impacts negatively in nutritional status. We evaluate the differences in nutritional status indicators and the association of high type transporter peritoneal with protein energy wasting (PEW) syndrome.

Methods

Cross-sectional study of a cohort of 36 patients with CKD on automated peritoneal dialysis (APD) [18 men, 18 women; age, 35.1 ± 13.3 years; dialysis duration, 7 (2-24) months]. Peritoneal transport characteristics were classified after a peritoneal equilibration test (PET). The PET study reasons were: baseline study, low ultrafiltration, underdialysis and after an event of peritonitis. Patients were classified according to peritoneal characteristics as a low transporter (LT) [low/low average] and as high transporter (HT) [high/high average transporters]. Weight and height were measured using standard procedures and body composition was assessed by multifrequency bioelectrical impedance analysis.

Results

HT individuals have lower albumin concentrations than LT (3.3 ± 0.42 vs 3.7 ± 0.39, p=0.026). Higher glucose absorption from dialysis solution (p=0.036) and a trend toward in higher c reactive protein plasma concentrations (p=0.089) was observed in the HT group. Higher prevalence of PEW condition (50 vs 23%) was observed in HT group without statistical significance (p=0.144). Higher malnutrition status using malnutrition inflammation score and PEW criteria was observed in HT-PET, without statistical significance.

Conclusion

HT peritoneal membrane confers a risk for hypoalbuminemia and inflammatory state in CKD patients on automated peritoneal dialysis. HT patients are at an increased risk of PEW. Intervention studies to elucidate the best nutritional approach should be designed to improve nutritional status in this population.