ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO1000

The Impact of Peritoneal and Urine Protein Losses on Nutritional Status in Peritoneal Dialysis Patients

Session Information

  • Peritoneal Dialysis
    November 04, 2021 | Location: On-Demand, Virtual Only
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 702 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Figueiredo, Cátia Raquel, Centro Hospitalar do Medio Tejo EPE Unidade de Torres Novas, Torres Novas, Santarém, Portugal
  • Roldão, Marisa, Centro Hospitalar do Medio Tejo EPE Unidade de Torres Novas, Torres Novas, Santarém, Portugal
  • Gonçalves, Hernâni Martins, Centro Hospitalar do Medio Tejo EPE Unidade de Torres Novas, Torres Novas, Santarém, Portugal
  • Ferrer, Francisco, Centro Hospitalar do Medio Tejo EPE Unidade de Torres Novas, Torres Novas, Santarém, Portugal
  • Sofia, Flora, Centro Hospitalar do Medio Tejo EPE Unidade de Torres Novas, Torres Novas, Santarém, Portugal
Background

The etiology of malnutrition in peritoneal dialysis (PD) patients is multifactorial, but the peritoneal protein losses (PPL) and proteinuria may be important contributing factors. We aimed to evaluate if the total protein losses (into urine and dialysate) in PD patients have an impact on their nutritional status.

Methods

A retrospective observational study of PD patients over the first year in PD. Demographic, clinical, and analytical data were collected at baseline (time of PD initiation), 6 and 12 months later. Nutritional status was assessed using normalized protein catabolic rate (nPCR), body mass index (BMI), lean body mass (LBM), and body fat mass (BFM). The total amount of 24h urine and dialysate protein losses (ProtUrDial) and delta (Δ) values (difference between the end of follow-up period and baseline) of continuous variables were also calculated.

Results

Twenty patients were enrolled (55.8±10.8 years; 65% male). Except for serum albumin (sAlb), which changed significantly from the baseline to the end of the follow-up period (p=0.001), there were no differences in protein loss into dialysate (ProtDial), proteinuria (ProtUrine), nPCR, BMI, LBM, and BFM over time. In the 3 time points there was a significative positive correlation between ProtUrine and nPCR (r=0.563, p=0.01; r=0.584, p=0.031; r=0.611, p=0.004, respectively). At the end of the follow-up period, we verified a negative correlation between sAlb and ProtUrDial (r=-0.477; p=0.033). There was no correlation between ΔProtDial and nutritional parameters status, however, there was a positive correlation between ΔProtUrine and ΔBMI (r=0.492; p=0.028). Regarding ΔProtUrDial, we verified a negative correlation with Δ%LBM (r=-0.664; p=0.026) and, although not significant, a positive correlation with Δ%BFM (r=0.573; p=0.066).

Conclusion

The PPL has already been linked to malnutrition in PD patients. However, we found that the total amount of protein losses daily (into urine and dialysate), and not each one individually, seems to influence the nutritional status of PD patients. Besides, proteinuria appeared to have a greater impact on nutritional changes than peritoneal losses. However, more studies with larger samples are needed to clarify this association.