Effects of Amino Acid Peritoneal Dialysate in Malnutrished Peritoneal Dialysis Patients

Aim: Malnutrition is common in peritoneal dialysis (PD) patients and hypoalbuminemia is a predictor of poor outcomes in end-stage renal disease patients. Amino acid peritoneal dialysate (AAPD) is used to improve nutritional status in malnourished PD patients. In this study, we investigated effects of AAPD on nutritional parameters in hypoalbuminemic PD patients. Methods: Sixteen (10 male and 6 female) patients, mean age 53.3±11.5 years old (range 36 to 70 years), mean dialysis duration 40.1 ± 31.0 months (range 4 to 99 months) and with serum albumin ≤ 3.9 g/dL were included in the study. Baseline and after three months of AAPD usage, nutritional parameters including, serum albumin, semiquantitative method of subjective global assessment (SGA), normalized protein catabolic rate (n-PCR) and lean body mass (LBM) were compared to evaluate the effects of AAPD on nutritional parameters in PD patients. Results: Thirteen patients completed the study. AAPD was well tolerated. After treatment blood urea nitrogen (BUN), albumin, n-PCR levels and SGA value increased. Serum albumin levels increased in 11 of 13 (84%) patients. However HDL cholesterol and creatinine clearance (CCr) decreased after AAPD. Conclusion: Amino acid peritoneal dialysate is an effective agent to improve nutritional status in PD patients and it is well tolerated. This is the second report about AAPD treatment showing the decrease in HDL cholesterol as a side effect. The mechanism and the effect of decreased HDL cholesterol need to be investigated in PD patients in larger and long-term studies.