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Perit Dial Int 1(6): 82-87
1981
© 1981 International Society for Peritoneal Dialysis
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REVIEWS AND ORIGINAL ARTICLES

NUTRITIONAL AND ANTHROPOMETRIC ASSESSMENT OF PATIENTS ON CAPD OVER ONE YEAR: CONTRASTING CHANGES IN TOTAL BODY NITROGEN AND POTASSIUM

Paul Williams, Ruth Kay, Joan Harrison, Kenneth McNeil, Jean Pettit, Betty Kelman, Maria Mendez, Michael Klein, Raymond Ogilvie, Ramesh Khanna, Don Carmichael and Dimitrios Oreopoulos

From the Departments of Medicine, Surgery, Immunology and Biochemistry, Toronto Western Hospital, the Medical Physics Laboratory, Toronto General Hospital and the University of Toronto.

Serial dietary, biochemical, total body nitrogen and potassium, anthropometric and immunological assessments were performed on 13 CAPD patients during their first year on CAPD. Their dietary protein and calorie intakes declined from 1.46 g/kg to 1.06 g/kg, and 36.5 Kcal/kg to 28.9 Kcal/kg respectively (p < 0.01). This decline was associated with a fall in total body nitrogen from 1768 g to 1498 g (p < 0.01) without significant changes in muscle mass or total body fat as assessed anthropometrically, and an actual increase in body weight -from 61.5 kg to 66.7 kg (p < 0.001) and increase in total body potassium (92.7 9 to 105 g, p < 0.01). 'The increase in body weight may have been due to an increase in total body water and, in the absence of edema, to an increase in intracellular water -a conclusion that is supported by the rise in total body potassium. The discrepancy between changes in total body nitrogen and potassium confirms the view that, in patients with renal failure, total body potassium is not a good index of lean body mass. Our findings suggest that CAPD patients may be in long-term negative nitrogen balance if their protein intake is maintained at 1.0 g/kg and this emphasizes the importance of nutritional support particularly during intercurrent illnesses such as peritonitis. Changes in total body potassium and body weight are not good indices of the nutritional status of these patients.






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