Nutrition, adequacy of dialysis, and clinical outcome in Indo-Asian and White European patients on peritoneal dialysis

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.