Document Detail

The normalized protein catabolic rate is a flawed marker of nutrition in CAPD patients.
MedLine Citation:
PMID:  8126998     Owner:  NLM     Status:  MEDLINE    
For both hemodialysis and CAPD patients nutrition has been linked to mortality. Protein calorie malnutrition is present in 20 to 40% of CAPD patients. The normalized protein catabolic rate (NPCR), has been proposed as a useful measure of dietary protein intake and ultimately nutrition. However, the NPCR value has not been consistently predictive of outcome in CAPD patients. We have performed a cross sectional study on 147 clinically stable CAPD patients, who had a mean dialysis duration 22 months, to evaluate the relationship between the NPCR and conventional markers of nutrition. The NPCR was significantly correlated with normalized models of dialysis adequacy including KT/V (urea), total weekly creatinine clearance and the dialysis index. A significant negative correlation was found between individual anthropometric measures and the NPCR. Using a composite nutritional index to nutritionally categorize our population we found a significantly higher NPCR value in the severely malnourished group. The unadjusted protein catabolic rate (PCR) was significantly correlated with individual nutritional measures and was significantly greater in the well-nourished group. The NPCR, obtained by dividing the PCR by body weight (itself a nutritional measure), is lowest in well-nourished or obese patients, and thus as a marker of nutrition may be flawed. The PCR has nutritional relevance, however, adjusting its value to take into account patient size will require prospective evaluation of the influence of small solute removal on body composition.
J C Harty; H Boulton; J Curwell; N Heelis; L Uttley; M C Venning; R Gokal
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Kidney international     Volume:  45     ISSN:  0085-2538     ISO Abbreviation:  Kidney Int.     Publication Date:  1994 Jan 
Date Detail:
Created Date:  1994-04-12     Completed Date:  1994-04-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  103-9     Citation Subset:  IM    
Renal Unit, Manchester Royal Infirmary, England, United Kingdom.
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MeSH Terms
Biological Markers
Body Weight
Diet Records
Dietary Proteins / administration & dosage
Middle Aged
Models, Biological
Nutritional Status*
Peritoneal Dialysis, Continuous Ambulatory* / methods
Proteins / metabolism*
Reference Values
Reg. No./Substance:
0/Biological Markers; 0/Dietary Proteins; 0/Proteins

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