Models to assess nitrogen losses in pediatric patients on chronic peritoneal dialysis

Pediatr Nephrol. 2000 Nov;15(1-2):25-30. doi: 10.1007/pl00013447.

Abstract

To develop models to estimate nitrogen (N) losses of children on chronic peritoneal dialysis (CPD) from easily measurable indexes and laboratory tests, we measured the N content and all nitrogenous compounds in dialysate (D), urine (U), and feces over 3 days in 19 pediatric patients on CPD. Total measured N losses (TNm) were 5.56+/-2.26 g/day (69.9+/-11.1% in dialysate, 16.3+/-10.6% in urine, and 13.6+/-4.6% in feces). Correlation coefficients between measured dialysate and urinary N losses and the single nitrogenous compounds indicated values of over 0.9 only for urea in dialysate and urine; fecal N losses correlated well with body surface area (BSA). Taking into account these correlations, we developed a univariate additive model and three multivariate models to predict total estimated N losses (TNe). The best prediction of TNm was obtained with model 3, which considered not only urea output in dialysate and urine but also dialysate protein loss and BSA: TNe (g/day)=0.03+/-1.138 UN urea+0.99 DN urea+1.18 BSA+0.965 DN protein. A confirmatory analysis performed on a second group of 23 pediatric patients on CPD, using all four models, showed a higher percentage of studies with a relative difference between TNm and TNe less than 10% for model 3 than for the other models. Thus, N losses of pediatric patients on CPD can be estimated from measured urea and protein losses in dialysate and urea loss in urine, together with BSA.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Analysis of Variance
  • Body Surface Area
  • Child
  • Child, Preschool
  • Creatinine / metabolism
  • Feces / chemistry
  • Humans
  • Models, Biological*
  • Nitrogen / metabolism*
  • Nitrogen / urine
  • Peritoneal Dialysis / adverse effects*
  • Peritoneal Dialysis, Continuous Ambulatory
  • Reproducibility of Results

Substances

  • Creatinine
  • Nitrogen