Nutritional status and body composition after 6 months of patients switching from continuous ambulatorial peritoneal dialysis to automated peritoneal dialysis

Our objective was to determine if automated peritoneal dialysis (APD) leads to changes in nutritional parameters of patients treated by continuous ambulatory peritoneal dialysis (CAPD). Twenty-six patients (15 males; 50.5 +/- 14.3 years) were evaluated during CAPD while training for APD and after 3 and 6 months of APD. Body fat was assessed by the sum of skinfold thickness and the other body compartments were assessed by bioelectrical impedance. During the 6-month follow-up, 12 patients gained more than 1 kg (GW group), 8 patients lost more than 1 kg ( LW group), and 6 patients maintained body weight ( MW group). Except for length on dialysis that was longer for the LW group compared with the GW group, no other differences were found between the groups at baseline. After 6 months on APD, the LW group had a reduction in body fat (24.5 +/- 7.7 vs 22.1 +/- 7.3 kg; P = 0.01), body cell mass (22.6 +/- 6.2 vs 21.6 +/- 5.8 kg, P = 0.02) and phase angle (5.4 +/- 0.9 vs 5.1 +/- 0.8 degrees, P = 0.004). In the GW group, body fat (25 +/- 7.6 vs 27.2 +/- 7.6 kg, P = 0.001) and body cell mass (20.1 +/- 3.9 vs 20.8 +/- 4.0 kg, P = 0.05) were increased. In the present study, different patterns of change in body composition were found. The length of previous dialysis treatment seems to be the most important factor in determining these nutritional modifications.