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  • Title: Nutrition, adequacy of dialysis, and clinical outcome in Indo-Asian and White European patients on peritoneal dialysis.
    Author: Bakewell A, Higgins R, Edmunds M.
    Journal: QJM; 2002 Dec; 95(12):811-20. PubMed ID: 12454324.
    Abstract:
    BACKGROUND: There is a high incidence of end-stage renal disease in Asians originating from the Indian subcontinent living in the UK. Research to date has focused on the cause of renal disease in Indo-Asians, and their outcome on peritoneal dialysis (PD) is less well studied. AIM: To determine whether nutrition, adequacy of dialysis, and outcome of Indo-Asian patients on PD were similar to those of White European patients. DESIGN: Prospective longitudinal observational study over 2 years. METHODS: We enrolled 35 Indo-Asians and 35 White Europeans on peritoneal dialysis, closely matched for age, gender, diabetes and duration of renal replacement therapy. At enrolment (>3 months on PD), demographic data was recorded. From enrolment, and at 6-month intervals, dialysis adequacy, nutritional status, hospitalizations, PD infections, and treatment modality changes were recorded. RESULTS: Dietary protein intake, which was significantly worse in Indo-Asians (particularly vegetarians), declined in all patients over time, along with other measures of nutritional status. Adequacy of dialysis, peritoneal characteristics, and PD infections were similar in Indo-Asian and White patients. Technique failure, and death rate were similar in both groups, but the transplant rate was lower in Indo-Asians. DISCUSSION: Interventions are needed to improve nutritional status in these patients, particularly the Indo-Asian patients. The long-term impact of worse social deprivation and lower transplant rates in Indo-Asians needs to be investigated further.
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