IMPACTS ON PROTEIN INTAKE IN PERITONEAL DIALYSIS PATIENTS

Abstract

The purpose of this study is to identify barriers related to achieving an adequate protein intake, and predictors of protein-energy wasting (PEW) in Peritoneal Dialysis (PD) patients. This is a prospective observational study of prevalent patients receiving PD in our facility. Data collection occurs at baseline and six months, including renal-related morbidity, biochemistry, weight, nutritional status (Subjective Global Assessment (SGA) and PEW criteria), energy and protein intake (via diet history), social situation and support, appetite and quality of life (EQ-5D). The following is a preliminary analysis of baseline characteristics, using chi-square, Fisher’s exact test and t-test, against protein intake less than or greater than the recommended 1.2 g/kg adjusted body weight (ABW). To date, 43 patients have been recruited, 56% (n=24) are male, with mean (SD) age 61 (12.3) years and BMI 28.5 (7.3) kg/m2. Of these, 16% (n=7) were assessed as malnourished (SGA B or C) and 93% (n=40) met one or more PEW criteria. Sixty percent (n=26) failed to meet minimum protein requirements 1.2 g protein/kg ABW (mean 1.08 (0.3) g protein/kg ABW). Inadequate protein intake was related to reliance on social security (p=0.05), having a diminished appetite (p=0.05) and lower reported quality of life (health utility index) (p=0.03). PEW was related to decreased mobility (p=0.05), difficulties with self care (p=0.001) and presence of pain/discomfort (p=0.01). In conclusion, inadequate protein intake was present in a significant portion of the population. Barriers to adequate intake in this population can include low income and appetite levels, which may concomitantly impact on quality of life. Further work on recruiting participants and longitudinal follow-up is currently underway to elucidate the impact of this on patient outcomes.