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Perit Dial Int 6(2): 53-58 1986
© 1986 International Society for Peritoneal Dialysis
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REVIEWS AND ORIGINAL ARTICLES

NUTRITIONAL ASSESSMENT AND SKELETAL MUSCLE FUNCTION IN PATIENTS ON CONTINUOUS AMBULATORY PERITONEAL DIALYSIS

Kostas Sombolos, Charles Berkelhammer, Jeffrey Baker, George Wu, Peter McNamee and Dimitrios G. Oreopoulos

From the Department of Medicine, Toronto Western Hospital and University of Toronto.

Nutritional status and skeletal muscle function were studied in 20 CAPD patients (12 men and eight women) who were randomly selected among a total population of 95 CAPD patients. Their ages ranged from 29 to 74 years -mean 59 -and they underwent CAPD for a period of one to 180 (mean 62.2 ± 53.3) weeks. Nutritional assessment included mea surement of body anthropometry, serum albumin, transferrin, C3 and C4, lymphocyte counts, total body nitrogen - nitrogen index (NI) and total body potassium (TBK). Function of the adductor pollicis muscle was assessed by electrical stimulation of the ulnar nerve, obtaining the force of contraction at 10 Hz expressed as a per cent of the force at lOO Hz (F l0/F lOO) and the maximal relaxation rate (MRR) expressed as % force loss/lO ms.

Seven of the 20 patients showed low nitrogen index (NI < 0.80), two had low transferrin levels <<1.70 mg/dl) and one had very low albumin levels (26 g/l). There was no statistically significant difference between the NI of men (0.84 &plusmn; 0.11) and women (0.90 &plusmn; 0.14). TBK varied among the patients with a mean value of 89.9 &plusmn; 11.8 g for women and 123.8 &plusmn; 25.3 g for men. In all patients, the relative force of contraction of adductor pollicis muscle at low frequencies (F l0/F 100) was within normallimits as was the MRR, which showed a small decrease only in three patients.

The results indicate that, although when assessed by conventional nutritional parameters some CAPD patients showed subtle indices of malnutrition and a significant proportion (7/20) have a low nitrogen index, most have well-preserved skeletal muscle function.

KEY WORDS: Nutrition; Muscle contractidity; Total body nitrogen; Total body potassium; Ontropometry.






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