H.S.XIAO1, G.H.LIM1, S.C.YEO1, Y.P.LIM1
Tan Tock Seng Hospital1
Regular dietetic interventions are hypothesised to improve the nutritional status of peritoneal dialysis (PD) patients. This aims to examine the effect of routine dietetic interventions on the nutritional status and anthropometric outcomes of PD patients.
Ninety-nine patients initiated on PD between 2016 and 2018 with follow-up till 2019, were retrospectively reviewed and analysed. Patients who declined dietitian’s consult or had fewer than 3 consults were excluded. Descriptive analysis was used to summarise the data, with appropriate tests of associations performed.
Thirty-three (33.3%) were malnourished at PD initiation and received dietetic consults 3-4 monthly. Among them, all had up to 1 year follow-up, 23 had up to 2 years follow-up, and 12 had up to 3 years follow-up. By 1 year, 84.9% became well-nourished with median body mass index (BMI) increased from 19.6 kg/m2 to 20.9 kg/m2 (p=0.006). Correspondingly, median mid-upper arm circumference (MUAC) improved from 23.5cm to 25.0cm (p= 0.014), and triceps skin thickness (TST) improved from 9.2mm to 12.5mm (p= 0.11). Among the 12 malnourished patients followed up to 3 years, 91.7% became well-nourished. Median BMI, MUAC and TST improved further to 22.4 kg/m2 (p= 0.23), 27.0cm (p=0.02) and 13.5mm (p = 0.48), respectively. 91% and 100% of well-nourished maintained status at 1 and 3 years, respectively.
Regular 3-4 monthly dietetic interventions improved the nutritional status of PD patients with above 80% malnutrition resolved by 12 months, maintained and further improved to above 90% by 36 months.