LB058 - PROTEIN LOSS IN RELATION TO DIALYSIS MODALITY
LB058
PROTEIN LOSS IN RELATION TO DIALYSIS MODALITY
H. Shaaker1,2,*, A. Davenport 3, S. Eaton 4
1Clinical Nutrition , King Abdulaziz University , Jeddah, Saudi Arabia, 2Division of Medicine , 3Centre for Kidney & Bladder Health, 4Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
Rationale: The growing use of automated peritoneal dialysis (APD), especially continuous cycling peritoneal dialysis (CCPD), in end-stage renal disease (ESRD) patients has raised concerns about increased nutrient losses compared to continuous ambulatory peritoneal dialysis (CAPD), potentially elevating the risk of malnutrition and sarcopenia. This study compared non-urea nitrogen losses across PD modalities to assess their nutritional impact and inform individualized nutrition care.
Methods: This cross-sectional study included 42 patients with end-stage renal disease (ESRD) undergoing peritoneal dialysis. Patients were categorized by modality: continuous ambulatory peritoneal dialysis (CAPD, 43%), continuous cycling peritoneal dialysis (CCPD, 43%), and automated peritoneal dialysis (APD, 14%). Twenty-four-hour dialysate effluent samples were collected and stored at –50°C. Total nitrogen was measured using the Antek MultiTek analyzer, and non-urea nitrogen loss was calculated by subtracting urea nitrogen from total nitrogen.
Results: A significant difference in non-urea nitrogen losses was observed across PD modalities (p < 0.001). CAPD patients exhibited higher losses (median 5.53 [4.6–6.1] g/day) compared to CCPD (2.71 [1.2–3.72] g/day, p < 0.001) and APD (3.72 [2.23–3.75] g/day, p = 0.009). No significant difference was found between CCPD and APD (p = 0.611). Despite CCPD’s longer dwell time, the continuous dialysis characteristic of CAPD likely accounts for its greater protein losses. These results indicate that longer total dialysis times may increase protein loss through the dialysate.
Conclusion: CAPD shows significantly higher non-urea nitrogen loss than automated modalities, indicating a greater risk of protein-energy wasting. Modality-specific nutritional care, including increased protein intake and regular assessments, may help preserve lean body mass and improve outcomes.
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Disclosure of Interest: None declared