The Long-term Nutritional Effects of Amino-Acid Based Dialysis Solution (IPAA) in Malnourished CAPD Patients : Comparison of Responders and Non-responders.
- Author:
So Rae CHOI
1
;
Yong Soo SONG
;
Soo Young YOON
;
Do Sik YUN
;
Soo Hyun AHN
;
Hyung Cheon PARK
;
Jong Ho LEE
;
Shin Wook KANG
;
Kyu Hun CHOI
;
Seong Kyu HA
;
Ho Yung LEE
;
Dae Suk HAN
Author Information
1. Department of Internal Medicine, The Institute of Kidney Disease, College of Medicine, Yonsei University, Seoul, Korea. dshan@yunc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Amino acid-based dialysis solution;
Malnutrition;
Continuous ambulatory peritoneal dialysis
- MeSH:
Creatinine;
Dialysis*;
Hand;
Hand Strength;
Humans;
Insulin-Like Growth Factor I;
Malnutrition;
Nutritional Status;
Peritoneal Dialysis, Continuous Ambulatory*;
Serum Albumin;
Urea
- From:Korean Journal of Nephrology
2002;21(5):767-779
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: IPAA provide nutritional benefit, at least in the short term. However, the long-term efficacy of IPAA in PD patients remains unclear. An attempt was made to evaluate long-term efficacy of IPAA and to ascertain possible factors associated with improved nutritional status after IPAA. METHODS: The 46 malnourished CAPD patients were treated with IPAA (one exchange of Nutrineal daily) for one year. Various nutritional, boichemical variables, urea kinetic study and measurement of lean body mass based on creatinine excretion (LBMCr) were carried out at baseline, and at 3- month interval thereafter. Responders was defined as those patients who had an increment of mean LBMCr more than 2.0 kg and/or an increase in mean %LBMCr (LBMCr/Body weight) more than 5% during IPAA treatment. RESULTS: After administration of IPAA, BUN, Cr, LBMCr, %LBMCr, nPNA, SGA, and exercise capacity increased significantly. But, protein and albumin level showed no significant change. Increment of IGF-1 level was significant. At baseline, responders had a significantly higher hand grip and back lift strength compared to non-responders. IPAA treatment significantly increased in BUN, PNA and nPNA in both groups, but the increment of them was pronounced in responders. IPAA resulted in a significant increase in serum creatinine (10.6+/-2.1 vs. 11.8+/-2.6 mg/dL, p<0.05) and %LBMCr (70.8+/-8.9 vs. 76.4+/-9.2%, p<0.05), hand grip strength (23.2+/-7.3 vs. 24.3+/-7.7 kg, p<0.05) and back lift strength (67.0+/-27.4 vs. 75.3+/-26.6 kg, p<0.05) only in responders. Serum albumin level remained stable after IPAA treatment in responders. CONCLUSION: IPAA treatment for 12 months provided some nutritional benefits in malnourished CAPD patients. And, our data suggest that response to IPAA is more pronounced in CAPD patients with a better preserved nutritional status, especially in those patients with higher back lift and hand grip strength at baseline.
