Nutritional effects of increasing dialysis dose by adding an icodextrin daytime dwell to Nocturnal Intermittent Peritoneal Dialysis (NIPD) in XXXX .

@entity1 @entity1522 @entity2002 @entity7245 @entity1133 @entity1160 @entity3793 @entity1011 @entity165
BACKGROUND: To assess the need to adapt dietary prescriptions, we studied potential effects of increasing the dialysis dose by adding a daytime icodextrin dwell, in @entity1 on Nocturnal Intermittent Peritoneal Dialysis (NIPD), on peritoneal @entity1522 (AA) and albumin loss, AA, albumin, @entity165 and @entity2002 plasma levels and nutritional intake. METHODS: A cross-over study in eight @entity1 (age 2-12 years) on NIPD at baseline (week 1). INTERVENTION: to increase dialysis dose we added a daytime dwell with 1100 ml/m(2) icodextrin solution for a week (week 2). MAIN OUTCOME MEASURES: peritoneal albumin loss (quantified by nephelometry) and @entity7245 (quantified by liquid chromatography mass spectrometry) in the last 72 h dialysate collections of weeks 1 and 2. On days 7 and 14, morning blood sample was taken for @entity1133 , @entity1011 , plasma AA levels, serum albumin, @entity165 and @entity2002 determination. Nutritional intake diaries were kept throughout the study period. RESULTS: Weekly dialysis creatinine clearance increased from 35 to 65 l/1.73 m(2) (P<0.0001) and Kt/V from 1.99 to 2.54 (P<0.01). Peritoneal albumin loss did not change significantly (2.4+/-0.4 to 2.4+/-0.3 g/m(2)/24 h) nor did serum albumin (3.25+/-0.52 to 3.21+/-0.25 g/dl), @entity165 (216+/-73 to 240+/-61 mg/dl) and @entity2002 (385+/-40 to 436+/-64 mg/dl). There was a significant increase in loss of essential (EAA) [1122+/-200 to 2104+/-417 mg/m(2)/week (P<0.0001)] and non-essential @entity1522 (NEAA) [6160+/-1341 to 10406+/-2899 mg/m(2)/week (P<0.001)]. Plasma AA levels did not change significantly except for a drop in @entity3793 and @entity1160 . Dietary protein intake did not change from 43+/-12 to 41+/-8 g/m(2)/day, caloric intake from 73+/-21 to 70+/-24 kcal/kg/day. CONCLUSIONS: Increasing dialysis dose by introducing a daytime icodextrin dwell during a week does not affect peritoneal albumin loss, serum albumin, @entity165 and @entity2002 levels nor dietary intake on a short term. There is a significant increase in EAA and NEAA loss without change in plasma levels. We suggest monitoring dietary intake when adding a daytime icodextrin dwell in @entity1 .
