The Nutritional Management of Patients with Continuous Ambulatory Peritoneal Dialysis

Abstract

End-stage kidney disease (ESKD) is a severe final phase of chronic kidney disease (CKD). Currently, it is related to high morbidity and mortality rates, making it an important health issue and a catastrophic disease. There is an increase in the death rate, especially when the underlying metabolic disorders are not treated with renal replacement therapy. Continuous ambulatory peritoneal dialysis (CAPD), or continuous dialysis in the peritoneal cavity, is one of the treatment options available in Indonesia as CKD becomes more prevalent each year, in addition to hemodialysis and kidney transplants. Patients with CKD who are on either hemodialysis or CAPD are frequently malnourished. The primary cause of these nutritional and metabolic disorders in uremic patients has decreased appetite, a major disease symptom. It is also observed that the protein levels in the serum and tissues are typically low, although protein and energy intake have been adjusted to meet standard nutritional guidelines. Also, there is reverse epidemiology in CKD patients, where a higher weight gain could result in a lower risk of mortality than non-CKD patients, where a higher weight gain causes an increased risk of death. Assessment and monitoring of nutritional status are necessary to determine mortality and morbidity due to cardiovascular abnormalities and for prevention and management of other complications in CKD patients undergoing CAPD. Lastly, there is currently a scarcity of research on the nutritional status of CAPD patients. Therefore, risk assessment and nutritional management monitoring can help reduce CKD incidence in patients undergoing CAPD.