Serum fibroblast growth factor–21 concentration is associated with residual renal function and insulin resistance in end-stage renal disease patients receiving long-term peritoneal dialysis

Background: This study analysed children with end-stage renal disease treated with automated peritoneal dialysis (APD) in our centre to explore the risk factors associated with residual renal function (RRF) loss. Methods: Children treated with APD as the initial renal replacement therapy regimen from January 2008 to December 2016 were included. All the children had a daily urine volume of ≥100 ml/m2 when APD was initiated and a dialysis follow-up time of ≥12 months. A daily urine volume of <100 ml/m2 after 12 months of APD treatment was defined as loss of RRF. Possible risk factors that may be associated with RRF loss were analysed. Results: A total of 66 children were included in the study. After 12 months of APD treatment, the daily urine volume decreased by 377.45 ± 348.80 ml/m2, the residual glomerular filtration rate decreased by 6.39 ± 3.69 ml/min/1.73 m2 and 29 of the patients (43.9%) developed RRF loss. The higher risk of RRF loss after 1 year of APD treatment was most pronounced in patients with daily urine volume of ≤400 ml/m2 before treatment, higher glucose exposure and higher ultrafiltration volume, while the lower risk of RRF loss was in patients with administration of diuretics. Each increase of 1 g/m2/day glucose exposure was associated with a 5% increase in RRF loss (odds ratio (OR) 1.05, p = 0.023) and each increase of 1 ml/m2/day ultrafiltration volume was associated with a 1% increase in RRF loss (OR 1.01, p = 0.013). Conclusion: In children undergoing APD, the risk for loss of RRF is associated with low urine volume at the start of APD, high glucose loading and high peritoneal ultrafiltration volume, while preservation of RRF is associated with the usage of diuretics.

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Allopurinol effects on residual renal function in end-stage renal disease patients undergoing peritoneal dialysis: Randomized controlled trial

Journal of Research in Pharmacy Practice ◽

10.4103/jrpp.jrpp_18_72 ◽

2019 ◽

Vol 8 (4) ◽

pp. 189

Author(s):

ElhamKabiri Naeini ◽

Firouzeh Moeinzadeh ◽

Mojgan Mortazavi

Keyword(s):

Randomized Controlled Trial ◽

Renal Function ◽

Peritoneal Dialysis ◽

Renal Disease ◽

End Stage Renal Disease ◽

Controlled Trial ◽

Residual Renal Function ◽

Randomized Controlled ◽

Stage Renal Disease ◽

End Stage

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Peritoneal dialysis in a Moroccan center: Prevalence and complications

Bulletin de la Dialyse à Domicile ◽

10.25796/bdd.v3i2.54793 ◽

2020 ◽

Vol 3 (2) ◽

pp. 93-103

Author(s):

Abdelaali Bahadi ◽

Sanaa Benbria ◽

Hicham Rafik ◽

Driss El Kabbaj

Keyword(s):

Quality Of Life ◽

Renal Function ◽

Peritoneal Dialysis ◽

Renal Disease ◽

End Stage Renal Disease ◽

Residual Renal Function ◽

Mechanical Complications ◽

Stage Renal Disease ◽

End Stage

Abstract : Introduction: Peritoneal dialysis (PD) is as effective as hemodialysis and often provides a better quality of life for patients. Despite this, the replacement therapy remains little established in our country with a prevalence of less than 1% of patients with end-stage renal disease. The objective of this work is to report the development and complications of PD in our center. Patients and methods: This is a retrospective study including all patients on PD between October 2008 and March 2019. We noted their demographic and clinical data at their initiation in peritoneal dialysis and we followed their evolution to discuss infectious and mechanical complications as well as the causes of PD exit. Results: During the study period, 456 patients were admitted for end-stage renal disease. Among these patients, only 28 (6.1%) were put on PD including two diabetics. Their average age was 37.7 years with a sex ratio of 0.8. The average body surface area was 1.59 m² with an average residual renal function of 6.05 ml / min. PD was chosen as the first intention in 20 patients while 8 patients were on hemodialysis. The evolution was marked by a median survival of the technique of 18.5 months characterized by 8 episodes of peritonitis in 4 patients corresponding to a rate of 1 episode over 56 months. Regarding mechanical complications, we noted 9 omentum aspirations, 1 leak in one case and 1 umbilical hernia requiring surgical recovery in a patient. Out of 28 patients, 17 discharges were identified; 10 patients (67%) were transferred to hemodialysis, 4 died and only 3 patients (18%) were transplanted. The final transfer to hemodialysis was related to mechanical complications in 5 cases, loss of ultrafiltration in one case, repeated hydro-sodium overload in one case, peritonitis in one case and social reasons in two cases. Conclusion: PD is an effective technique which preserves residual renal function and quality of life but its prevalence remains low in the order of 6% of patients treated for end-stage renal disease. The complications are dominated in our context by the mechanical complications main cause of final transfer in hemodialysis.

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Predictors of Loss of Residual Renal Function among New Dialysis Patients

Journal of the American Society of Nephrology ◽

10.1681/asn.v113556 ◽

2000 ◽

Vol 11 (3) ◽

pp. 556-564 ◽

Cited By ~ 10

Author(s):

LOUISE M. MOIST ◽

FRIEDRICH K. PORT ◽

SEAN M. ORZOL ◽

ERIC W. YOUNG ◽

TRULS OSTBYE ◽

...

Keyword(s):

Renal Function ◽

Peritoneal Dialysis ◽

Renal Disease ◽

End Stage Renal Disease ◽

Residual Renal Function ◽

Prior History ◽

History Of ◽

Stage Renal Disease ◽

End Stage

Abstract. Residual renal function (RRF) in end-stage renal disease is clinically important as it contributes to adequacy of dialysis, quality of life, and mortality. This study was conducted to determine the predictors of RRF loss in a national random sample of patients initiating hemodialysis and peritoneal dialysis. The study controlled for baseline variables and included major predictors. The end point was loss of RRF, defined as a urine volume <200 ml/24 h at approximately 1 yr of follow-up. The adjusted odds ratios (AOR) and P values associated with each of the demographic, clinical, laboratory, and treatment parameters were estimated using an “adjusted” univariate analysis. Significant variables (P < 0.05) were included in a multivariate logistic regression model. Predictors of RRF loss were female gender (AOR = 1.45; P < 0.001), non-white race (AOR = 1.57; P = <0.001), prior history of diabetes (AOR = 1.82; P = 0.006), prior history of congestive heart failure (AOR = 1.32; P = 0.03), and time to follow-up (AOR = 1.06 per month; P = 0.03). Patients treated with peritoneal dialysis had a 65% lower risk of RRF loss than those on hemodialysis (AOR = 0.35; P < 0.001). Higher serum calcium (AOR = 0.81 per mg/dl; P = 0.05), use of an angiotensin-converting enzyme inhibitor (AOR = 0.68; P < 0.001), and use of a calcium channel blocker (AOR = 0.77; P = 0.01) were independently associated with decreased risk of RRF loss. The observations of demographic groups at risk and potentially modifiable factors and therapies have generated testable hypotheses regarding therapies that may preserve RRF among end-stage renal disease patients.

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