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Perit Dial Int 29(3): 319-324
2009
© 2009 International Society for Peritoneal Dialysis
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Clinical

A STRICT LOW PROTEIN DIET DURING THE PREDIALYSIS PERIOD SUPPRESSES PERITONEAL PERMEABILITY AT INDUCTION OF PERITONEAL DIALYSIS

Takeshi Hasegawa1,2, Ashio Yoshimura1, Makoto Hirose1, Daisuke Komukai1, Hironori Tayama1, Susumu Watanabe1, Fumihiko Koiwa1, Shin Yamazaki2 and Terukuni Ideura1

Division of Nephrology,1 Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama; Department of Epidemiology and Healthcare Research,2 Kyoto University Graduate School of Medicine and Public Health, Kyoto, Japan

Correspondence to: T. Hasegawa, Division of Nephrology, Department of Internal Medicine, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama, Kanagawa, 227-8501, Japan. t-hasegawa{at}showa-university-fujigaoka.gr.jp

{diamondsuit} Background: The factors that predict baseline peritoneal permeability remain largely unknown. We noticed that patients that adhered to a strict low protein diet (LPD) during the predialysis period seldom showed high peritoneal permeability on the peritoneal equilibration test (PET) at the introduction of peritoneal dialysis (PD). Therefore, we investigated whether a strict LPD during the predialysis period affects peritoneal permeability.

{diamondsuit} Method: We retrospectively analyzed 37 patients that started PD in a single Japanese center. Patients were divided into group A and group B by the median amount of daily protein intake (PI) during the predialysis period using urine collected over 24 hours.

{diamondsuit} Results: There were no differences between groups A and B in age, gender, proportion of diabetic nephropathy, blood pressure, body mass index, or body surface area. There were also no differences between the groups in laboratory findings, including hematocrit, serum albumin, and serum creatinine. The PETs showed a significantly lower dialysate-to-plasma ratio of creatinine at 4 hours (Cr D/P) for group A than for group B (p = 0.02). Furthermore, a significant positive correlation between Cr D/P and PI was observed (r = 0.53, p < 0.01).

{diamondsuit} Conclusion: It is suggested that a strict LPD during the predialysis period may suppress peritoneal permeability at induction of PD.

KEY WORDS: Low protein diet; peritoneal permeability; peritoneal equilibration test.

Received 17 January 2008; accepted 2 September 2008.




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