Relationship of Normalized Protein Catabolic Rate with Nutrition Status and Long-Term Survival in Peritoneal Dialysis Patients. 2015

Paul A Fein, and Stacey Weiss, and Morrell M Avram, and Francis Ramos, and Priyanka Singh, and Sein Yin See, and Madeeha Shahzadi, and Jyotiprakas Chattopadhyay

The normalized protein catabolic rate (nPCR) reflects daily dietary protein intake in stable dialysis patients. In peritoneal dialysis (PD) patients, reports about the importance of nPCR as marker of nutrition and outcome have been inconsistent. The objective of the present study was to investigate the relationships of nPCR with body composition parameters, micronutrient electrolytes, and long-term survival in PD patients. From November 2000 to May 2008, 57 PD patients were enrolled in the study. On enrollment, demographic, clinical, and biochemical data were recorded. Patients were followed through September 2011. Mean age of the patients was 56 years, and 61% were of African descent. Mean and maximum follow-up were 2.83 years and 11 years respectively. Mean daily nPCR was 0.944 g/kg. The nPCR correlated directly with albumin (r = 0.34, p = 0.012), magnesium (r = 0.48, p < 0.0001), phosphorus (r = 0.42, p = 0.02), and the phase angle body composition parameter (r = 0.26, p = 0.049). Compared with patients whose enrollment daily nPCR was less than 0.8 g/kg, those with an enrollment daily nPCR of 0.8 g/kg or more experienced significantly better 11-year cumulative survival (p = 0.04). In multivariate Cox regression analysis with adjustment for confounding variables, nPCR was an independent predictor of all-cause mortality (p = 0.018). In conclusion, lower nPCR is associated with poorer nutrition status and increased risk of all-cause mortality in PD patients followed for up to 11 years.

UI MeSH Term Description Entries
D007676 Kidney Failure, Chronic The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION. ESRD,End-Stage Renal Disease,Renal Disease, End-Stage,Renal Failure, Chronic,Renal Failure, End-Stage,Chronic Kidney Failure,End-Stage Kidney Disease,Chronic Renal Failure,Disease, End-Stage Kidney,Disease, End-Stage Renal,End Stage Kidney Disease,End Stage Renal Disease,End-Stage Renal Failure,Kidney Disease, End-Stage,Renal Disease, End Stage,Renal Failure, End Stage
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009752 Nutritional Status State of the body in relation to the consumption and utilization of nutrients. Nutrition Status,Status, Nutrition,Status, Nutritional
D010530 Peritoneal Dialysis Dialysis fluid being introduced into and removed from the peritoneal cavity as either a continuous or an intermittent procedure. Dialyses, Peritoneal,Dialysis, Peritoneal,Peritoneal Dialyses
D012044 Regression Analysis Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable. Regression Diagnostics,Statistical Regression,Analysis, Regression,Analyses, Regression,Diagnostics, Regression,Regression Analyses,Regression, Statistical,Regressions, Statistical,Statistical Regressions
D001823 Body Composition The relative amounts of various components in the body, such as percentage of body fat. Body Compositions,Composition, Body,Compositions, Body
D004044 Dietary Proteins Proteins obtained from foods. They are the main source of the ESSENTIAL AMINO ACIDS. Proteins, Dietary,Dietary Protein,Protein, Dietary
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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