A comparison between Automated and Continuous ...

Nutrition and Quality of Life Outcomes in Peritoneal Dialysis – A comparison between Automated and Continuous Ambulatory Peritoneal Dialysis Jessica Barbon1, Anthony Meade2, Sue Ranner3 1Flinders

University, South Australia; 2 Central Northern Adelaide Renal and Transplantation Service, South Australia; 3 Flinders Medical Centre, South Australia

Objective: To assess and compare the nutritional status, oral intake and self rated Quality of Life (QoL) in a sample of South Australian Peritoneal Dialysis (PD) patients undergoing Continuous Ambulatory Peritoneal Dialysis (CAPD) or Automated Peritoneal Dialysis (APD) Subjects & Setting: 10 adult CAPD and 37 APD patients on home-based peritoneal dialysis for ≥ 3 months. Subjects were excluded if they had a hospital admission within the preceding 2 months, or a peritonitis episode during the preceding month, or were receiving palliative care. Methods: • Physical Assessment - Subjects were weighed with fluid in, and then corrected for volume of dialysate (1kg per litre). Patients were considered to have maintained weight from initiation of dialysis if weight was within ±2.5%. Weight change outside these parameters was classified as clinically significant weight change. Adjusted Body Weight (AdjBW) was used for energy and protein requirement calculations. AdjBW was calculated at a BMI of 20kg/m2 for underweight participants, 25kg/m2 for overweight participants, and current weight was used for participants within the healthy BMI range of 20kg/m2 to 25kg/m2. PG-SGA was completed at time of nutrition assessment • Nutrition Assessment – Subjects completed a three day food diary (including two week days and one weekend day). Data was cross-checked with the subject at the time of assessment. The dietary intake records were entered into FoodWorks (Xyris Software) for daily average macro and micro nutrient analyses. Energy intake from dialysate glucose absorption was calculated and included in total energy intake. Glucose absorption from dialysate was estimated at 40% for APD and 60% for CAPD, with Icodextrin absorption at 20% of the dialysate glucose concentration and volume. • Quality of Life (QoL) - was determined by completion of the SF-36 health survey at the time of nutrition assessment. Results & Discussion: • Mean annual percentage weight change was not significantly different between modalities • Per month on PD, 25.5% (n=12) of patients lost weight and 59.6% (n=28) gained weight from initiation of therapy until date of assessment. • Differences between CAPD and APD for both PG-SGA mean numerical score and categorical score were non-significant. • GI symptoms were expressed in 48.9% (n=23) of the PD sample, with appetite loss experienced in 38.3% (n=18), and taste changes in 14.9% (n=7). There was no difference between PD modalities for the presence of these symptoms. • PG-SGA score was correlated with the presence of GI symptoms (r=-0.619, p