scholarly journals P1207ANALYSIS OF OUTCOME AND FACTORS ASSOCIATED WITH MAINTENANCE OF PERITONEAL DIALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Merita Rroji (Molla) ◽  
Saimir Seferi ◽  
Larisa Shehaj ◽  
Myftar Barbullushi
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Residual Renal Function ◽  
Good Survival ◽  
First Year ◽  
Technical Failure ◽  
Technique Survival ◽  
Ultrafiltration Failure ◽  
Comorbidity Index ◽  
Short Time

Abstract Background and Aims Peritoneal dialysis (PD) is generally associated with a good survival rate and with great preservation of residual renal function (RRF). The various causes of technique failure are responsible for the relative short time staying in PD. Objectives: This study aimed to analyze the outcome and factors correlated with maintenance peritoneal dialysis (PD) to guide for improving prognosis. Method In a retrospective way we examined our PD-cohort concerning mortality, technique survival, peritonitis rate, and other complications. Results From 2005 to 2019 the number of PD patients who have been treated in PD program for more than 3 months was around 199 patient, 29.1% diabetics, mean age 53.3±15.03 years old and meantime in therapy 32.39± 27.34 months. The PD was seen as an alternative for younger patients in the transplant list and elderly patients with comorbidity. Around 7.5% of the PD patients were transplanted and 8.5 % of patients were transferred from HD due to vascular access failure. Around 88.9% of patients were on PD for more than 1 year, 37.7% from 3 up to 5 years and 19.8% percent of the patients have stayed on PD for more than 5 years. Cardiovascular mortality was the main cause of mortality with 53% of the cases. Higher comorbidity index, lower albumin levels, and lower residual renal function were the main risk factors for lower survival. The technical survival of patients was 92.3% during the first year, 79.5% and 69.6% in the second and the fifth year, respectively. There was not found a difference in technical survival between diabetics and nondiabetics patients. Ultrafiltration failure followed by peritonitis was the main reason for transfer patients with more than 24 months in therapy in hemodialysis probably linked with the no availability of icodextrin. Peritonitis rate was 1:41 patient months. Conclusion PD program in our center is organized based in the concept of integrated care in RRT. The outcome of our patients was at least comparable to those reported by larger registries Although we have done good progress in the prevention of infection the nonavailability of icodextrin is an important factor for a technical failure. RRF is an important factor and we need to be more focused to maintain it longer in the future.

Peritoneal Dialysis Clearance can Replace Residual Renal Function

2001 ◽  
Vol 21 (3) ◽  
pp. 263-268 ◽  
Author(s):  
Nabeel Aslam ◽  
Judith Bernardini ◽  
Linda Fried ◽  
Beth Piraino
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Residual Renal Function ◽  
First Year ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Dialysis Patients ◽  
Technique Survival ◽  
Cox Proportional Hazard ◽  
One Year

Objective There is controversy whether increasing peritoneal clearance effectively substitutes for declining residual renal function. We studied the impact of renal and peritoneal clearances on outcome, controlling for comorbidity. Design Registry database. Settings Four dialysis centers. Patients Incident peritoneal dialysis patients. Methods Data were collected prospectively on 90 incident patients between 1991 and 1999. At the end of their first year on peritoneal dialysis, patients were divided into groups based on the first year's clearance results: group 1 ( n = 62) had weekly Kt/V greater than or equal to 2.0 and creatinine clearance (CCr/1.73 m2) greater than or equal to 60 L throughout the first year; group 2 ( n = 28) fell below these targets due to loss of residual renal function and then reached targets due to prescription change. Main Outcome Measures Patient and technique survival. Results Both groups were similar in baseline characteristics except age (57 years vs 49 years, p = 0.02) and initial albumin (34.4 g/L vs 37.5 g/L, p = 0.001). One-year patient survival after grouping was similar in both groups (86.3% vs 80.9%, p = 0.72). Cox proportional hazard model, controlling for comorbidity, did not show “group” to be a significant predictor of outcome ( p = 0.96). One-year technique survival after grouping was similar in both groups (77.3% vs 83.2%, log rank p = 0.89). For technique failure, Cox proportional hazard model showed peritonitis ( p = 0.004) to be the only significant predictor of worse outcome. Conclusions Peritoneal dialysis patients with improved clearances due to prescription changes had survival comparable to patients who never fell below target. This suggests that loss of residual renal function may be replaced by increasing peritoneal dialysis clearance. A large multicenter trial to study this important question further is needed.

scholarly journals SP483EXCESS WEIGHT GAIN DURING THE FIRST YEAR OF PERITONEAL DIALYSIS IS A RISK FACTOR FOR A RAPID DECREASE IN RESIDUAL RENAL FUNCTION

2015 ◽  
Vol 30 (suppl_3) ◽  
pp. iii539-iii539
Author(s):  
Hyung Jik Kim ◽  
Sung Gyun Kim ◽  
Jwa-Kyung Kim ◽  
Chan Ho Kim ◽  
Seung Jun Kim ◽  
...  
Keyword(s):  
Renal Function ◽  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Weight Gain ◽  
Residual Renal Function ◽  
Rapid Decrease ◽  
First Year

scholarly journals Peritoneal Glucose Exposure and Changes in Membrane Solute Transport with Time on Peritoneal Dialysis

2001 ◽  
Vol 12 (5) ◽  
pp. 1046-1051 ◽  
Author(s):  
SIMON J. DAVIES ◽  
LOUISE PHILLIPS ◽  
PATRICK F. NAISH ◽  
GAVIN I. RUSSELL
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Solute Transport ◽  
Residual Renal Function ◽  
Causative Role ◽  
Continuous Exposure ◽  
Hypertonic Glucose ◽  
Ultrafiltration Failure ◽  
Glucose Exposure

Abstract. Peritoneal solute transport increases with time on treatment in a proportion of peritoneal dialysis (PD) patients, contributing to ultrafiltration failure. Continuous exposure of the peritoneum to hypertonic glucose solutions results in morphologic damage that may have a causative role in changes in peritoneal function. The purpose of this analysis was to establish whether increased exposure to glucose preceded changes in solute transport in a selected group of long-term PD patients. Peritoneal solute transport, residual renal function, peritonitis rate, and peritoneal exposure to glucose were recorded prospectively in a cohort of 303 patients at a single dialysis center. A subgroup of individuals, treated continuously for 5 yr, were identified and defined retrospectively as having either stable or increasing transport status. Of the 22 patients who were treated continuously for 5 yr, 13 had stable solute transport (solute transport at start, 0.67 [±0.1]; at 5 yr, 0.67 [±0.1]), whereas 9 had a sustained increase (solute transport at start, 0.56 [±0.08]; at 5 yr, 0.77 [±0.09]). Compared with the stable patients, those with increasing transport had earlier loss in residual renal function and were exposed to significantly more hypertonic glucose during the first 2 yr of treatment that preceded the increase in solute transport. This was associated with greater achieved ultrafiltration compensating for the reduced urinary volumes in these patients. Further increases in glucose exposure were observed as solute transport continued to rise. Peritonitis, including severity of infection and causative organism, was similar in both groups. In this selected group of long-term survivors on PD, an increase in solute transport with time was preceded by increased peritoneal exposure to hypertonic glucose. This is supportive evidence that hypertonic glucose may play a causative role in alterations in peritoneal membrane function.

Impact of Cardiovascular Events on Residual Renal Function during the First Year of Peritoneal Dialysis

2007 ◽  
Vol 27 (4) ◽  
pp. 454-456 ◽  
Author(s):  
Francisco Coronel ◽  
Isabel Pérez-Flores ◽  
Natividad Calvo ◽  
Maria Martínez-Villaescusa ◽  
Secundino Cigarrán
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Cardiovascular Events ◽  
Residual Renal Function ◽  
First Year

scholarly journals Experiences with Assisted Peritoneal Dialysis in China

2012 ◽  
Vol 32 (1) ◽  
pp. 94-101 ◽  
Author(s):  
Rong Xu ◽  
Min Zhuo ◽  
Zhikai Yang ◽  
Jie Dong
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Self Care ◽  
Residual Renal Function ◽  
First Episode ◽  
Survival Times ◽  
Single Center Experience ◽  
Risk Of Mortality ◽  
Charlson Comorbidity Score ◽  
Comorbidity Index

ObjectiveAbout half the patients on peritoneal dialysis (PD) in China need to be assisted by family members or home assistants. We explored whether these patients have a higher risk for peritonitis and death compared with self-care PD patients.MethodsWe prospectively followed 313 incident PD patients until death or censoring. This cohort was divided into assisted and self-care PD groups according to the independence of bag exchange. Data on baseline demographics, Charlson comorbidity index, biochemistry, and residual renal function were recorded during the first 3 – 6 months. The outcome variables were first episode of peritonitis and all-cause mortality.ResultsOf the 313 patients in this cohort study, 122 needed assistance in performing bag exchanges (86 from a family member, 36 from a home assistant); the remaining 191 patients did not need assistance. During a follow-up period averaging 44.5 months, 122 patients developed a first episode of peritonitis, and 135 patients died. Compared with patients having a family assistant, those with a home assistant had similar peritonitis-free and survival times, but a higher risk of mortality after adjustments for variables such as age, sex, Charlson comorbidity score, hemoglobin, serum albumin, and residual renal function. Furthermore, compared with self-care patients, assisted patients overall had a similar peritonitis-free time, but a higher risk of mortality, even after adjusting for covariates.ConclusionsBased on our single-center experience in China, we conclude that assisted PD is a good option for patients with poor self-care ability. This result provides evidence for recruiting patients who need assistance to PD programs in China.

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