scholarly journals Independent effects of residual renal function and dialysis adequacy on dietary micronutrient intakes in patients receiving continuous ambulatory peritoneal dialysis

2002 ◽  
Vol 76 (3) ◽  
pp. 569-576 ◽  
Author(s):  
Angela Yee-Moon Wang ◽  
Mandy Man-Mei Sea ◽  
Ricky Ip ◽  
Man Ching Law ◽  
Kai Ming Chow ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Residual Renal Function ◽  
Dialysis Adequacy ◽  
Independent Effects

scholarly journals Impact of Dialysis Adequacy on the Mortality and Morbidity of Anuric Chinese Patients Receiving Continuous Ambulatory Peritoneal Dialysis

2001 ◽  
Vol 12 (2) ◽  
pp. 355-360 ◽  
Author(s):  
CHEUK-CHUN SZETO ◽  
TERESA YUK-HWA WONG ◽  
KAI-MING CHOW ◽  
CHI-BON LEUNG ◽  
MAN-CHING LAW ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Patient Survival ◽  
Residual Renal Function ◽  
The Body ◽  
Chinese Patients ◽  
Dialysis Adequacy ◽  
Technique Survival

Abstract. Dialysis adequacy has a major impact on the outcome of continuous ambulatory peritoneal dialysis (CAPD) patients. However, most studies on peritoneal dialysis adequacy have focused on patients with significant residual renal function. The present study examined the effect of dialysis adequacy on anuric CAPD patients. A single-center prospective observational study on 140 anuric CAPD patients was performed. These patients were followed for 22.0 ± 11.9 mo. Dialysis adequacy and nutritional indices, including Kt/V, creatinine clearance (CCr), protein equivalent nitrogen appearance, percentage of lean body mass, and serum albumin level were monitored. Clinical outcomes included actuarial patient survival, technique survival, and duration of hospitalization. In the study population, 64 were male, 36 (25.7%) were diabetic, and 59 (42.1%) were treated with 6 L exchanges per day. The body weight was 59.2 ± 10.2 kg. Average Kt/V was 1.72 ± 0.31, and CCr was 43.7 ± 11.5 L/wk per 1.73m2. Two-yr patient survival was 68.8%, and technique survival was 61.4%. Multivariate analysis showed that DM, duration of dialysis before enrollment, serum albumin, and index of dialysis adequacy (Kt/V or CCr) were independent factors of both patient survival and technique survival. It was estimated that for two patients who differed only in weekly Kt/V, a 0.1 higher value was associated with a 6% decrease in the RR of death (P < 0.05; 95% confidence interval, 0.92 to 0.99). Serum albumin and CCr were the only independent factors that predicted hospitalization. It was found that even when there is no residual renal function, higher dialysis dosage is associated with better actuarial patient survival, better technique survival, and shorter hospitalization. Dialysis adequacy has a significant impact on the clinical outcome of CAPD patients, and the beneficial effect is preserved in anuric patients as well as in an ethnic group that has a low overall mortality.

Independent Effects of Renal and Peritoneal Clearances on the Mortality of Peritoneal Dialysis Patients

2004 ◽  
Vol 24 (1) ◽  
pp. 58-64 ◽  
Author(s):  
Cheuk-Chun Szeto ◽  
Teresa Yuk-Hwa Wong ◽  
Kai-Ming Chow ◽  
Chi-Bon Leung ◽  
Man-Ching Law ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Patient Survival ◽  
Residual Renal Function ◽  
University Teaching ◽  
Dialysis Adequacy ◽  
Protein Nitrogen ◽  
Technique Survival ◽  
Independent Effects

Objective Previous studies show that peritoneal Kt/V is an independent predictor of survival in anuric patients receiving continuous ambulatory peritoneal dialysis (CAPD). We studied whether peritoneal Kt/V has the same effect in CAPD patients with residual renal function. Design Observational cohort study. Setting Single dialysis center in a university teaching hospital. Patients New and prevalent CAPD patients. Methods We examined the 5-year follow-up results of our prospective study previously reported ( Kidney Int 2000; 58:400–7). A total of 270 CAPD patients were followed for up to 6 years. Dialysis adequacy indices, residual renal function, and nutritional data were monitored. Outcome Measures Primary outcomes included mortality and technique failure. Peritoneal Kt/V rather than total Kt/V was used for multivariate survival analysis. Results Average duration of follow-up was 35.1 ± 22.0 months. Average peritoneal Kt/V throughout the study was 1.59 ± 0.37; median residual glomerular filtration rate (GFR) 0.82 mL/minute. Five-year actuarial patient survival was 41.5%, and technique survival was 23.1%. Multivariate analysis showed that sex, age, duration of dialysis, presence of diabetes, serum albumin, dialysate-to-plasma creatinine ratio at 24 hours, peritoneal Kt/V, residual GFR, and normalized protein nitrogen appearance were independent factors of both actuarial patient survival and technique survival. For every 0.1 unit higher peritoneal Kt/V, relative mortality risk was 0.94 (95% CI 0.89 – 0.99, p = 0.03). When prevalent and new CAPD cases were analyzed separately, peritoneal Kt/V predicted survival only for prevalent CAPD patients. Conclusion We conclude that, in prevalent CAPD patients with relatively low levels of peritoneal clearance and residual renal function, a higher peritoneal Kt/V is associated with better survival. Peritoneal clearance below 1.6 – 1.7 likely has a major detrimental effect on the clinical outcome of CAPD patients with little residual renal function.

scholarly journals Residual renal function and blood count in patients on continuous ambulatory peritoneal dialysis

2006 ◽  
Vol 134 (11-12) ◽  
pp. 503-508
Author(s):  
Natasa Jovanovic ◽  
Mirjana Lausevic ◽  
Biljana Stojimirovic
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Peritoneal Dialysis ◽  
Chronic Renal Failure ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Blood Count ◽  
Residual Renal Function ◽  
Co Morbidity ◽  
Positive Correlations

Introduction:Most of patients with chronic renal failure are affected by normochromic, normocytic anemia caused by different etiological factors. Anemia causes a series of symptoms in chronic renal failure, which can hardly be recognized from the uremic signs. Anemia adds to morbidity and mortality rates in patients affected by advanced chronic renal failure. Blood count partially improves during the first months after starting the chronic renal replacement therapy, in correlation with the quality of depuration program, with extension of erythrocyte lifetime and with hemoconcentration due to reduction of plasma volume. Recent trials found that higher residual renal function (RRF) significantly reduced co-morbidity, the rate and duration of hospitalization and risk of treatment failure. Objective: The aim of the study was to follow blood count parameters in 32 patients on chronic continuous ambulatory peritoneal dialysis (CAPD) during the first six months of treatment, to evaluate the influence of demographic and clinical factors on blood count and RRF, and to examine the correlation between RRF and blood count parameters. Method: A total of 32 patients affected by end-stage renal disease of different major cause during the first six months of CADP treatment were studied. RRF and blood count were evaluated as well as their relationship during the follow-up. Results: Blood count significantly improved in our patients during the first six months of CAPD treatment even if Hb and HTC failed to reach normal values. Iron serum level slightly decreased because of more abundant erythropoiesis and iron utilization during the first six months of treatment. RRF slightly decreased. After six months of CAPD treatment, the patients with higher RRF had significantly higher Hb, HTC and erythrocyte number and a lot of positive correlations between RRF and anemia markers were observed. Conclusion: After 6-month follow-up period, the patients with higher RRF had significantly higher blood count parameters, and several positive correlations between RRF and blood count markers were confirmed.

Residual Renal Function Affects Lipid Profile in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

1997 ◽  
Vol 17 (3) ◽  
pp. 243-249 ◽  
Author(s):  
Alexander Kagan ◽  
Eti Elimalech ◽  
Zvi Lerner ◽  
Aaron Fink ◽  
Yaacov Bar-Khayim
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Lipid Profile ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Density Lipoprotein ◽  
Serum Levels ◽  
Residual Renal Function ◽  
Lipoprotein Cholesterol ◽  
Group A ◽  
Group B

Objective To determine whether lipoprotein abnormalities associated with continuous ambulatory peritoneal dialysis (CAPD) are influenced by residual renal function (RRF). Design Open, non randomized prospective and com -parative study. Setting Single university teaching hospital dialysis unit and outpatient clinic. Patients Twenty adult patients on standard CAPD (1 -38 months) were divided into two groups: group A (RRF ≤ 0.8 mL/min, n = 10) and group B (RRF ≥ 1.1 mL/ min, n = 10). Patients in the two groups were matched for age, time on dialysis, body weight, body mass index, serum urea and albumin levels, peritoneal and urinary albumin losses, and peritoneal transport characteristics such as overnight 8hour peritoneal creatinine and β2-microglobulin clearances and overnight 8-hour effluent glucose concentrations. Results The degree of uremia in patients with preserved RRF (group B) was obviously lower than in patients with negligible RRF (group A), that is, patients in group B had significantly lower serum creatinine and β2-microglobulin levels and significantly higher weekly KTN than group A patients. Despite the prevalence of allele 4 of apolipoprotein E genotype in group A patients, their levels of serum total cholesterol, low-density lipoprotein cholesterol, lipoprotein (a) [Lp(a)], apolipoprotein B (ApoB), and apolipoprotein A1 (ApoA1) were significantly lower than those of patients with preserved RRF (group B). The two groups did not differ significantly in the serum levels of triglyceride or high-density lipoprotein cholesterol. Serum concentrations of Lp(a) and ApoA1, as well as ratios of ApoA1 to ApoB, were correlated significantly with RRF (r = 0.63, r = 0.51, and r = 0.61, respectively). Conclusions The findings suggest that RRF affects the lipid profile of CAPD patients, especially serum levels of cholesterol-rich lipoproteins.

Careful Patient Selection and Dialysis Prescription are Required for Effective Nightl Y Intermittent Peritoneal Dialysis

1994 ◽  
Vol 14 (2) ◽  
pp. 155-158 ◽  
Author(s):  
Jean L. Holley ◽  
Beth Piraino
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Serum Creatinine ◽  
Clinical Status ◽  
Residual Renal Function ◽  
Peritoneal Equilibration Test ◽  
Dialysis Adequacy ◽  
Continuous Cycling ◽  
Continuous Peritoneal Dialysis ◽  
Dialysis Time

Objective To evaluate the adequacy of dialysis in patients on nighttime intermittent peritoneal dialysis (NIPD). Design Retrospective review of prospectively collected data. Patients Seven patients on NIPD. Measurements The fast peritoneal equilibration test (PET) was used to determine peritoneal membrane permeability for small solutes. Adequacy of dialysis measured by 24hour collections of dialysate and urine for weekly KT/V and creatinine clearance in liters/week/1.73 m2 was assessed in patients with (n=3) and without (n=4) residual renal function and evaluated in concert with the patient's clinical status. Outcome for each patient was also noted. Results Five of the patients had a high-average dialysate/serum creatinine by PET (>0.66). Despite a weekly KT/V of 1.7 or more, four of the seven patients on NIPD were uremic and either transferred to hemodialysis or continuous cycling peritoneal dialysis (CCPD). A fifth patient had a KT/V of 1.4 and was also uremic on NIPD. The patient who was clinically well and continued on NIPD had significant residual renal function. Conclusions NIPD should be restricted to patients with high-average dialysate/serum creatinine as determined by PET and residual renal function or those with high dialysate/serum creatinine. Extended dialysis time and large volumes of dialysate are required for successful NIPD in patients without residual renal function. Accepted parameters of dialysis adequacy used for patients on continuous peritoneal dialysis are not appropriate for intermittent forms of peritoneal dialysis.

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