The Relevance of Diuresis on Nutrition Studied in 26 Patients Undergoing Peritoneal Dialysis

Giancarlo Ruggieri

Recently, clinicians have questioned the advisability to save the diuresis in patients come to the need of a substitutive treatment. This interest drove us to look at the strategy of incremental dialysis, based on progressively increasing dialytic treatment, with the purpose of delaying the loss of diuresis for as long a time as possible. This work aimed to study the importance of residual diuresis, analyzing the differences of nutritional data in a population of 26 patients undergoing peritoneal dialysis. Of the 26 patients, 18 of them had diuresis and 8 of them were anuric. The nutritional data of patients with diuresis were compared with those without diuresis. The same was performed between patients with diuresis of greater than the average of diuresis versus those with a significantly lower diuresis. The relationships between the total clearances and nutritional data were analyzed, as well as between nutritional data and the attained creatinine clearance/volume of creatinine (KT/V), this also to state the need of a predefined KT/V value to maintain adequate nutritional conditions. It was shown that, in the studied population, no significant differences of nutrition resulted between patients with and without diuresis and in patients with diuresis when separating them in two groups having significant difference of diuresis, nor were significant differences found in nutrition data and the attained KT/V. The final conclusion is that the value of residual glomerular filtration rate (GFR) to signal the start of incremental dialysis treatment should not be based on a predefined value in all patients, but should be tailored according to the specific needs of each patient.