Protein losses during acute intermittent peritoneal dailysis.
ABSTRACT: Aims : The losses of protein into the dialysate have been considered a primary limiting factor and drawback of peritoneal dialysis. Hypoalbuminaemia is a major risk factor for mortality and morbidity in dialysis patients, which is a product of poor intake, protein restriction and protei...
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| Language: | English |
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c2001.
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| LEADER | 04956 a2200241 4500 | ||
|---|---|---|---|
| 003 | OSt | ||
| 005 | 20220906184544.0 | ||
| 008 | 190211b ||||| |||| 00| 0 eng d | ||
| 952 | |0 0 |1 0 |2 NLM |4 0 |6 THS_00056_PRA_2001_000000000000000 |7 0 |9 517 |a NHRC |b NHRC |c REF |d 2012-07-12 |l 0 |o THS-00056/PRA/2001 |p THS-00056 |r 2012-07-12 |w 2012-07-12 |y TR | ||
| 999 | |c 511 |d 511 | ||
| 060 | |a THS-00056 | ||
| 100 | |a Pradhan, Bijendra Raj. |9 1643 | ||
| 245 | |a Protein losses during acute intermittent peritoneal dailysis. | ||
| 260 | |c c2001. | ||
| 300 | |a viii, 78p. | ||
| 500 | |a Thesis Report. | ||
| 520 | |a ABSTRACT: Aims : The losses of protein into the dialysate have been considered a primary limiting factor and drawback of peritoneal dialysis. Hypoalbuminaemia is a major risk factor for mortality and morbidity in dialysis patients, which is a product of poor intake, protein restriction and protein losses during peritoneal dialysis. So this study focuses at the comprehensive evaluation of protein losses in patients undergoing acute intermittent peritoneal dialysis to achieve the following aims, 1. To study the total amount of protein losses in different patients undergoing acute intermittent peritoneal dialysis. 2. To observe the condition where a relatively higher amount of protein loss occurs and hence the measures of its prevention 3. To see whether any correlation can be established between the peritoneal protein loss and the change in respective serum protein level, if any at the end of dialysis Method: A prospective study of 51 consecutive patients of varying ages and sexes, who had attended Bir Hospital for acute peritoneal dialysis, irrespective of diagnosis were done during the period extending from 057/10/24 to 058/01/19 i.e. from Jan 6, 2001 to Apr 14,2001. Peritoneal dialysis was performed in all patients with aseptic precautions. Just prior to the peritoneal dialysis blood was drawn for -Complete blood count, Blood Urea, Creatinine, Electrolytes and Serum Protein and Albumin. Immediately after the end of dialysis, blood samples were again taken for above maintioned tests. The amount of peritoneal dialysis effluent that was seen as outflow after every cycle of dialysis, was collected in the same container. At the end of dialysis, the total amount of effluent that was collected was mixed thoroughly and was sent for analysis of protein and albumin. In addition to this, if the patients showed the signs and symptoms of peritonitis, the peritoneal fluid was also taken for total cell count, protein and sugar estimation and Gram stain along with culture and sensitivity. Results: The majority of the patients who had undergone peritoneal dialysis were males (69%). The mean age group of the patients in the study group was 43.29 +- 18.91, with age ranging from 12 to 87 years. 78% patients were suffering from Chronic Renal Failure, 12% from Rapidly Progressive Renal Failure and 5% from Acute Renal failure. After Peritoneal Dialysis, 82% patients showed improvement while in 18% Peritoneal Dialysis had to be discontinued and the cause of discontinuation was PD failure in (4%) patients and death before the completion of total cycles of dialysis in (14%) patients. The mean amount of protein loss in patients without peritonitis, during 48 hour of dialysis 20.64+-8.81 g. Similarly the mean total albumin loss in the effluent was 10.24+- 4.40 g. There was no statistically significant correlation between losses of various proteins and change in their respective serum concentrations (p>0.05). Peritonitis was seen in only one case, the amount of protein and albumin loss in that case reached to 114.14g and 68.48 g respectively. Conclusion: This study evaluated the comprehensive loss of protein and albumin during peritoneal dialysis. Without peritonitis, 20.64+-8.81 g of protein were lost per 48 hours of dialysis, whereas the total albumin loss was 10.24 +- 4.40 g. However the protein loss increased substantially during peritonitis with loss reaching to 114.14 g. The serum concentration of protein and albumin did not change significantly after the end of dialysis and their concentrations did not seem to have any influence on their respective loss in the peritoneal effluent. Similarly there was no significant correlation between the amount of different protein loss in the peritoneal effluent and their respective change in the serum concentration at the end of dialysis. Thus as a conclusion, in absence of peritonitis, dialysate protein loss does not appear to be a major factor limiting the usefulness of Peritoneal Dialysis. In addition from the amount of dialysate protein losses we can recommended that in the patients undergoing intermittent peritoneal dialysis, there is need for a greater protein intake. | ||
| 546 | |a Eng. | ||
| 650 | |a Protein. |9 1732 | ||
| 650 | |a Peritoneal. |9 1733 | ||
| 650 | |a Dialysis. |9 1734 | ||
| 856 | |u http://nhrc.gov.np/contact/ |y Visit NHRC Library | ||
| 942 | |2 NLM |c TR | ||