HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Wang, A. Y.-M. Articles by Woo, J. Search for Related Content PubMed PubMed Citation Articles by Wang, A. Y.-M. Articles by Woo, J. Agricola Articles by Wang, A. Y.-M. Articles by Woo, J.

Independent effects of residual renal function and dialysis adequacy on dietary micronutrient intakes in patients receiving continuous ambulatory peritoneal dialysis^1,2,3

¹ From the Department of Medicine & Therapeutics, Center for Nutritional Studies, Prince of Wales Hospital, Chinese University of Hong Kong.

Background: Dialysis patients are at risk of vitamin and mineral deficiencies, not only because of losses during chronic hemodialysis or peritoneal dialysis but also because of low intakes.

Objective: The objective was to determine the importance of urea clearance (calculated as K_t/V) and residual renal function (RRF) in predicting micronutrient intakes in a large cohort of patients receiving continuous ambulatory peritoneal dialysis (CAPD).

Design: We conducted a survey of dietary intakes in 242 CAPD patients and divided them into 3 groups according to their weekly urea clearance and RRF: WD group (n = 84), a urea clearance 1.7 and a glomerular filtration rate (GFR) 1 mL • min^-1 • 1.73 m^-2; DD group (n = 71), a urea clearance 1.7 and a GFR < 1 mL • min^-1 • 1.73 m^-2; and ID group (n = 87), a urea clearance < 1.7.

Results: Most of the patients had intakes of water-soluble vitamins and minerals that were lower than the recommended dietary allowance; most intakes were significantly higher in the WD group than in the DD and ID groups, except those of niacin and calcium. After age, sex, body weight, and the presence of diabetes were controlled for, total weekly urea clearance and the GFR (but not peritoneal dialysis urea clearance) were significantly associated with intakes of vitamins A and C, the B vitamins, and minerals (calcium, phosphate, iron, and zinc). Low intakes of vitamins and minerals with low RRF and urea clearance were the result of reduced overall food intakes, except for thiamine, vitamin B-6, and folic acid, which were deficient in the diet.

Conclusions: Supplementation with most water-soluble vitamins and minerals, including iron and zinc, should be considered in CAPD patients, especially those with low RRF and low urea clearance. The optimal dose needs to be determined.

Key Words: Vitamins • minerals • nutrition • peritoneal dialysis • continuous ambulatory peritoneal dialysis • CAPD • glomerular filtration rate • residual renal function • dialysis adequacy • macronutrient intakes • People’s Republic of China