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Article: A 3-year, prospective, randomized, controlled study on amino acid dialysate in patients on CAPD

TitleA 3-year, prospective, randomized, controlled study on amino acid dialysate in patients on CAPD
Authors
KeywordsAmino acid dialysate
Malnutrition
Nutrineal
Peritoneal dialysis (PD)
Issue Date2003
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/ajkd
Citation
American Journal Of Kidney Diseases, 2003, v. 42 n. 1 SUPPL. 2, p. 173-183 How to Cite?
AbstractBackground: Malnutrition is prevalent in patients on continuous ambulatory peritoneal dialysis (CAPD) and confers a poor prognosis. Inadequate nutrient intake is an important contributing factor. Although short-term studies have shown mild to modest nutritional benefit with amino acid dialysate, its long-term effects and tolerability remain obscure. Methods: The authors have performed a 3-year, randomized, prospective, controlled study of amino acid dialysate in malnourished Chinese patients on CAPD. Sixty patients were assigned randomly to either replace 1 exchange daily with amino acid dialysate (Nutrineal; DAA group, n = 30) or to continue with dextrose dialysate (Dianeal; DD group, n = 30). Results: The 2 groups had similar mortality, hospitalization duration, serial C-reactive protein levels, and drop-out rates during the study. Biochemical nutritional parameters including albumin and cholesterol decreased in the DD group but remained stable or increased in the DAA group. The composite nutritional index did not differ between the 2 groups throughout the study period. Triglyceride decreased only in DAA-treated patients. Normalized protein equivalent of nitrogen appearance and dietary protein intake showed a sustained increase only in DAA patients. The nutritional benefit of DAA appeared more prominent in women, whose lean body mass and body mass index was maintained with DAA but not with DD. Mass transfer area coefficient for creatinine increased in DAA-treated patients, whereas that for urea as well as macromolecular restriction coefficients remained stable. Total Kt/V urea and daily ultrafiltration volume were similarly maintained in the 2 groups throughout the study. Conclusion: Long-term administration of amino acid dialysate is well tolerated and presents a means to improve the nutritional status in high-risk patients. The current study, however, has not shown a significant effect of amino acid dialysate on patient survival. © 2003 by the National Kidney Foundation, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/162705
ISSN
2015 Impact Factor: 6.269
2015 SCImago Journal Rankings: 2.313
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLi, FKen_HK
dc.contributor.authorChan, LYYen_HK
dc.contributor.authorWoo, JCYen_HK
dc.contributor.authorHo, SKNen_HK
dc.contributor.authorLo, WKen_HK
dc.contributor.authorLai, KNen_HK
dc.contributor.authorChan, TMen_HK
dc.date.accessioned2012-09-05T05:22:33Z-
dc.date.available2012-09-05T05:22:33Z-
dc.date.issued2003en_HK
dc.identifier.citationAmerican Journal Of Kidney Diseases, 2003, v. 42 n. 1 SUPPL. 2, p. 173-183en_HK
dc.identifier.issn0272-6386en_HK
dc.identifier.urihttp://hdl.handle.net/10722/162705-
dc.description.abstractBackground: Malnutrition is prevalent in patients on continuous ambulatory peritoneal dialysis (CAPD) and confers a poor prognosis. Inadequate nutrient intake is an important contributing factor. Although short-term studies have shown mild to modest nutritional benefit with amino acid dialysate, its long-term effects and tolerability remain obscure. Methods: The authors have performed a 3-year, randomized, prospective, controlled study of amino acid dialysate in malnourished Chinese patients on CAPD. Sixty patients were assigned randomly to either replace 1 exchange daily with amino acid dialysate (Nutrineal; DAA group, n = 30) or to continue with dextrose dialysate (Dianeal; DD group, n = 30). Results: The 2 groups had similar mortality, hospitalization duration, serial C-reactive protein levels, and drop-out rates during the study. Biochemical nutritional parameters including albumin and cholesterol decreased in the DD group but remained stable or increased in the DAA group. The composite nutritional index did not differ between the 2 groups throughout the study period. Triglyceride decreased only in DAA-treated patients. Normalized protein equivalent of nitrogen appearance and dietary protein intake showed a sustained increase only in DAA patients. The nutritional benefit of DAA appeared more prominent in women, whose lean body mass and body mass index was maintained with DAA but not with DD. Mass transfer area coefficient for creatinine increased in DAA-treated patients, whereas that for urea as well as macromolecular restriction coefficients remained stable. Total Kt/V urea and daily ultrafiltration volume were similarly maintained in the 2 groups throughout the study. Conclusion: Long-term administration of amino acid dialysate is well tolerated and presents a means to improve the nutritional status in high-risk patients. The current study, however, has not shown a significant effect of amino acid dialysate on patient survival. © 2003 by the National Kidney Foundation, Inc.en_HK
dc.languageengen_US
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/ajkden_HK
dc.relation.ispartofAmerican Journal of Kidney Diseasesen_HK
dc.subjectAmino acid dialysateen_HK
dc.subjectMalnutritionen_HK
dc.subjectNutrinealen_HK
dc.subjectPeritoneal dialysis (PD)en_HK
dc.subject.meshAdulten_US
dc.subject.meshAmino Acids - Administration & Dosage - Therapeutic Useen_US
dc.subject.meshC-Reactive Protein - Analysisen_US
dc.subject.meshCholesterol - Blooden_US
dc.subject.meshDialysis Solutions - Administration & Dosage - Therapeutic Useen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshKidney Failure, Chronic - Blood - Complications - Therapyen_US
dc.subject.meshMaleen_US
dc.subject.meshMalnutrition - Etiology - Therapyen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPeritoneal Dialysis, Continuous Ambulatoryen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshSerum Albumin - Analysisen_US
dc.subject.meshSurvival Analysisen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleA 3-year, prospective, randomized, controlled study on amino acid dialysate in patients on CAPDen_HK
dc.typeArticleen_HK
dc.identifier.emailLai, KN: knlai@hku.hken_HK
dc.identifier.emailChan, TM: dtmchan@hku.hken_HK
dc.identifier.authorityLai, KN=rp00324en_HK
dc.identifier.authorityChan, TM=rp00394en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/S0272-6386(03)00421-9en_HK
dc.identifier.pmid12830470-
dc.identifier.scopuseid_2-s2.0-0038724617en_HK
dc.identifier.hkuros81798-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0038724617&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume42en_HK
dc.identifier.issue1 SUPPL. 2en_HK
dc.identifier.spage173en_HK
dc.identifier.epage183en_HK
dc.identifier.isiWOS:000183890500021-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLi, FK=8219093900en_HK
dc.identifier.scopusauthoridChan, LYY=8108378300en_HK
dc.identifier.scopusauthoridWoo, JCY=7401752874en_HK
dc.identifier.scopusauthoridHo, SKN=36839065300en_HK
dc.identifier.scopusauthoridLo, WK=7201502414en_HK
dc.identifier.scopusauthoridLai, KN=7402135706en_HK
dc.identifier.scopusauthoridChan, TM=7402687700en_HK

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