Conventional nutritional counselling maintains nutritional status of patients on continuous ambulatory peritoneal dialysis in spite of systemic inflammation and decrease of residual renal function

  1. FABIOLA MARTÍN-DEL-CAMPO1,
  2. LILIANA GONZÁLEZ-ESPINOZA1,
  3. ENRIQUE ROJAS-CAMPOS1,
  4. NORMA RUIZ2,
  5. JUANA GONZÁLEZ3,
  6. LEONARDO PAZARÍN4,
  7. ALFONSO M CUETO-MANZANO1,*

Article first published online: 10 JUN 2009

DOI: 10.1111/j.1440-1797.2008.01081.x

Issue

Nephrology

Nephrology

Volume 14, Issue 5, pages 493–498, August 2009

Additional Information

How to Cite

MARTÍN-DEL-CAMPO, F., GONZÁLEZ-ESPINOZA, L., ROJAS-CAMPOS, E., RUIZ, N., GONZÁLEZ, J., PAZARÍN, L. and CUETO-MANZANO, A. M. (2009), Conventional nutritional counselling maintains nutritional status of patients on continuous ambulatory peritoneal dialysis in spite of systemic inflammation and decrease of residual renal function. Nephrology, 14: 493–498. doi: 10.1111/j.1440-1797.2008.01081.x

Author Information

  1. 1

    Unit of Medical Research in Renal Diseases, Hospital de Especialidades, CMNO,

  2. 2

    Nephrology Department, Hospital General Regional No. 46,

  3. 3

    Nephrology Department, Hospital General Regional No. 110, and

  4. 4

    Internal Medicine Department, Hospital General de Zona No. 14, IMSS, Guadalajara, Mexico

*Dr Alfonso M Cueto-Manzano, Unidad de Investigación Médica en Enfermedades Renales, Hospital de Especialidades, CMNO, IMSS, B. Domínguez No. 1000, Col. Independencia CP 44320, Guadalajara, Mexico. Email: a_cueto_manzano@hotmail.com

Publication History

  1. Issue published online: 23 JUL 2009
  2. Article first published online: 10 JUN 2009
  3. Accepted for publication 21 November 2008.

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Keywords:

  • continuous ambulatory peritoneal dialysis;
  • inflammation;
  • nutritional counselling;
  • protein-calorie malnutrition;
  • residual renal function

SUMMARY

Aim:  To evaluate the effect of nutritional counselling on nutritional status in peritoneal dialysis patients.

Methods:  Twenty-nine peritoneal dialysis patients were randomly selected to receive conventional nutritional counselling during 6 months of follow up. All patients had monthly clinical and biochemical evaluations, and assessments of dialysis adequacy, inflammation and nutritional status at 0, 3 and 6 months.

Results:  Moderate-severe malnutrition decreased 28% whereas normal nutrition increased 23% at final evaluation (non-significant). Calorie and protein intake remained stable throughout the study (baseline vs final, calorie: 24 ± 8 vs 23 ± 5 Kcal/kg; protein: 1.1 ± 0.5 vs 1.0 ± 0.3 g/Kg, respectively). On the other hand, triceps (16 ± 6 vs 18 ± 8 mm) and subscapular (17 ± 8 vs 20 ± 5 mm) skinfold thicknesses, and mid-arm circumference (27 ± 3 vs 28 ± 3 mm) significantly increased; mid-arm muscle area displayed a non-significant trend to increase (30 ± 9 vs 31 ± 9 cm2) whereas serum albumin significantly increased at the end of study (2.67 ± 0.46 vs 2.94 ±  0.48 g/dL). At final evaluation, median renal creatinine clearance decreased (6.3 (0.8–15.3) vs 2.0 (0.1–6.3) L/week per 1.73 m2) whereas interleukin-6 increased (2.33 (1.9–7.0) vs 4.02 (2.1–8.4) pg/mL).

Conclusion:  Even though conventional nutritional counselling, as an isolated measure, did not significantly improve all nutritional parameters, it prevented a greater deterioration during 6 months. Nutritional counselling maintained the nutritional status in spite of a decrease in residual renal function and higher systemic inflammation.

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