THE RELATIONSHIP BETWEEN INDICES OF DIALYSIS ADEQUACY AND NUTRITIONAL STATUS AND UREMIC SYMPTOMS IN CAPD PATIENTS

We examined the relationship between quantitative indices of dialysis adequacy and nutritional status and patient-reported uremic symptomss in 20 CAPD patients. The Kt/Vurea, weekly total creatinine clearance (TCC), residual renal function (RRF), dialysis index (DI), normalized protein catabolic rate (NPCR) and serum albumin levels (SA) were calculated as indices of dialysis adequacy and nutritional status. The checklist consisted of 7 uremic symptoms, each scored from 0-3. The total symptom score was negatively correlated with Kt/Vurea (p<0.01), weekly TCC (p=0.01), DI (p<0.05), NPCR (p=0.001) and SA (p<0.0001). In patients whose total symptom score was higher than 7, Kt/Vurea (p<0.001), weekly TCC (p<0.01), RRF (p< 0.01), DI (p<0.05), NPCR (p<0.0001) and SA (p< 0.0001) were significantly lower than those in others. CAPD was intensified in patients considered to be inadequately dialyzed according to kinetic parameters with resolution of the uremic symptoms. In conclusion, dialysis dose prescription according to kinetic parameters is very useful in preventing uremic symptoms inpatients with CAPD.