The Nutritional Status of Long-Term CAPD Patients

Abstract

Since the introduction of continuous ambulatory peritoneal dialysis (CAPD) 11 years ago, several potentially harmful metabolic factors have been identified.⁽¹⁾ Proteins, amino acids, and other water-soluble nutrients are continuously lost into dialysate effluent. The absorption of glucose and lactate from dialysate provides a large energy supply (300–700 kcal/day). This may be desirable in the undernourished but can induce or accentuate hypertriglyceridemia and obesity in others. Peritonitis is an additional factor that may compromise nutritional status. Anorexia is a common occurrence, especially in the elderly. Intercurrent illness or surgery may place the patient in a catabolic state. There are increasing numbers of elderly patients being accepted into dialysis programs, as well as other “high-risk” patients, and senescence is associated with a decrease in protein and fat stores.