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2017 ; 6
(3
): 143-149
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Advanced wasting in peritoneal dialysis patients
#MMPMID28540204
Xu Z
; Murata GH
; Glew RH
; Sun Y
; Vigil D
; Servilla KS
; Tzamaloukas AH
World J Nephrol
2017[May]; 6
(3
): 143-149
PMID28540204
show ga
AIM: To identify patients with end-stage renal disease treated by peritoneal
dialysis (PD) who had zero body fat (BF) as determined by analysis of body
composition using anthropometric formulas estimating body water (V) and to
compare nutritional parameters between these patients and PD patients whose BF
was above zero. METHODS: Body weight (W) consists of fat-free mass (FFM) and BF.
Anthropometric formulas for calculating V allow the calculation of FFM as V/0.73,
where 0.73 is the water fraction of FFM at normal hydration. Wasting from loss of
BF has adverse survival outcomes in PD. Advanced wasting was defined as zero BF
when V/0.73 is equal to or exceeds W. This study, which analyzed 439 PD patients
at their first clearance study, used the Watson formulas estimating V to identify
patients with V(Watson)/0.73 ? W and compared their nutritional indices with
those of PD patients with V(Watson)/0.73 < W. RESULTS: The study identified at
the first clearance study two male patients with V(Watson)/0.73 ? W among 439
patients on PD. Compared to 260 other male patients on PD, the two subjects with
advanced wasting had exceptionally low body mass index and serum albumin
concentration. The first of the two subjects also had very low values for serum
creatinine concentration and total (in urine and spent peritoneal dialysate)
creatinine excretion rate while the second subject had an elevated serum
creatinine concentration and high creatinine excretion rate due, most probably,
to non-compliance with the PD prescription. CONCLUSION: Advanced wasting (zero
BF) in PD patients, identified by the anthropometric formulas that estimate V,
while rare, is associated with indices of poor somatic and visceral nutrition.
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