Relationship Between Dietary Protein Intake(DPI)and Loss Of Residual Renal Function In Peritoneal Dialysis Patients

[Purpose]Residual renal function in renal end-stage patients with dialysis is very important. In addition to the elimination of toxins, reduce complications, better quality of life is also one of the important factors. However, continue to accumulate as the dialysis time, regardless of hemodialysis (Hemodialysis, HD) or peritoneal dialysis (Peritoneal dialysis, PD) patients, residual renal function will gradually decline, but the speed of the decline of residual renal function in peritoneal dialysis patients with is generally slower than hemodialysis patients. There are many studies have shown that low-protein diet can reduce the burden on the kidneys, delaying the degree of residual renal function, and improve related symptoms in dialysis patients, but a simple low-protein diet may cause malnutrition in patients with additional services to the preparation of keto acid can be added essential amino acids, improve body nitrogen balance and reduce complications. In this study, the different protein intake peritoneal dialysis patients with different protein intake observed residual renal function, and whether taking keto acid.[Methods]We enrolled the patients of the First Affiliated Hospital of Zhejiang University of Nephrology from November2010to October2011who dialysis1-2months, dialysis adequacy, good daily energy intake, including33males,28females; aged35to78(52.4 ±13.8) years old; according to the patient’s diet, divided into daily protein intake in1.2g/kg/dhigh-protein group (n=12),0.8to1.2g/kg/d protein group (31cases), less than0.8g/kg/d the low-protein group (18cases). Observed in patients1month of treatment,6months,12months residual renal function (residual renal function, RRF), urine and peritoneal dialysis ultrafiltration volume changes, and compare RRF of each group taking keto acid or. Another comparison groups dialysate lost protein and urine protein differences in residual renal function changes with the peritoneal transport type.[Results]There was no significant difference in the amount of urine and peritoneal dialysis ultrafiltration, residual renal function at6months did not significantly change, but the high protein group and middle amount of protein group at12months residual renal function were decreased (P<0.05), and the high-protein group of residual renal function decreased significantly more,and rCcr have decreased significantly (P<0.01), rCcr. In all patients, whether taking keto acid, residual renal function at12months have shown a downward trend (P<0.05), but a taking keto acid residual renal function was significantly higher than nonusers (P<0.05); high-protein group, whether taking keto acid, residual renal function at12months have shown a downward trend (P<0.05); RRF of middle amount of protein group at12months patients taking keto acid residual renal function has not decreased significantly (P>0.05), but no taking have downward trend (P<0.05); low-protein group at12months were not significantly different (P>0.05). peritoneal albumin leakage and urinary protein loss was no difference (P>0.05). The peritoneal albumin leakage of peritoneal high transshipment group of low transporter patients are difference ((P<0.05)), but RRF of the two groups at12months have shown a downward trend (P<0.05), no significant difference between the two groups.[Conculusions] Low-protein diet can effectively protect residual renal function in peritoneal dialysis patients, delaying the progression of renal disease. Peritoneal dialysis patients take keto acids at first can protect residual renal function; middle protein group were treated with keto acids can effectively protect residual renal function, low protein group no significant impact, but the high-protein group failed to slow the rate of decline of residual renal function. Protein loss is related with peritoneal type, but has nothing to do with the protein intake, and does not affect the degree of patients with residual renal function.