Dietary Protein Intake and Peritoneal Protein Losses in Peritoneal Dialysis Patients

INTRODUCTION: Peritoneal dialysis (PD) patients lose protein in their waste dialysate, potentially increasing their risk for malnutrition. We wished to determine whether there was any association between losses and dietary protein intake (DPI). METHODS: DPI was assessed from 24-h dietary recall using Nutrics software. Total protein losses were measured in 24-h collections of spent dialysate and urine. RESULTS: We studied, 41 patients, mean age 62.2 ± 15.8 years, 56.1% male, treated for 14.0 (3-23) months. Only13 (31.7%) met the recommended DPI target of ≥ 1.0 g/kg/day, and they had greater peritoneal protein losses 5.2 ± 2.4 versus 3.3 ± 1.1 g/day, p < 0.001, and faster peritoneal solute transfer rates (PTSR ×100 for protein 0.93 (0.58-1.21) versus 0.44 (0.35-0.56), p < 0.001). On multivariate analysis DPI was associated with calorie intake (standardized beta coefficient (Stꞵ) 0.56, p < 0.001, and peritoneal protein clearance rate (Stꞵ 0.36, p = 0.002). CONCLUSION: Patients with faster protein clearance and protein losses had higher DPI.