Dialysis

Abstract. Kinetic analysis was performed in all 58 patients undergoing standard CAPD. The urea distri-bution volume was estimated from anthropomorphic measurements (Watson formulae). Normalized protein catabolic rate (NPCR)r daily protein leak (PL)r urea and creatinine Kt/Vs, clearances and peritoneal mass transfer coefficients (Kp) were calculated from meas-urements on serum, 24-h urine and PD fluid effluent. The mean total (renal+ PD) daily creatinine and urea Kt/Vs (KT/V) were 0.31 (range 0.15-0.79) and 0.31 (0.18-0.65). There was no relationship between KT/V and serum urea or Kp. The strongest determin-ant of the urea KT/V was the residual renal urea clearance (KT\J)(R = 0J9, P<0.001) which decreased with time on dialysis (/? = —0.38, P< 0.005). There was a significant correlation between the hospital admissions per year and both the urea and creatinine KT/V and KrU (R =-0.30,-0.32, F<0.05). Patients with urea KT/V < 0.25 (n = 22) had more hospital admissions/year than those with KT/V> 0.25 (mean of 2.6 versus 1.5, i><0.05). NPCR correlated with urea KT/V ( £ = 0.62, P< 0.001) but not with serum albumin or the PL. Patients identified by UKM to be less well dialysed have a lower residual renal function and are more likely to be hospitalized. Undernutrition in CAPD patients appears to be related to underdialysis rather than protein loss. Key words: adequacy; CAPD; kinetic analysis; morbid-ity; nutritio