SAT0184 MAINTENANCE THERAPY WITH AZATHIOPRINE ASSOCIATED WITH HIGHER RISK OF FLARE IN PROLIFERATIVE LUPUS NEPHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1033-1034
Author(s):  
M. Luis ◽  
A. R. Prata ◽  
H. Assunção ◽  
J. A. P. Da Silva ◽  
L. Inês
Keyword(s):  
Renal Function ◽  
Lupus Nephritis ◽  
Maintenance Therapy ◽  
Arterial Hypertension ◽  
Antihypertensive Drugs ◽  
Angiotensin Receptor Blockers ◽  
Univariate Analysis ◽  
Unmet Need ◽  
Induction Treatment ◽  
Frequent Event

Background:Goals of lupus nephritis (LN) maintenance treatment include prevention of LN flares and long-term preservation of renal function, while minimizing drug iatrogenicity. There is an unmet need for identifying predictors of LN flare in order to guide optimization of maintenance immunosuppression.Objectives:To identify predictors of LN flare after attainment of complete renal response (CRR) in patients with proliferative LN.Methods:Retrospective cohort study over 36 months including patients with SLE fulfilling the ACR’97 and/or the SLICC’12 classification criteria, enrolled in the CHUC Lupus Cohort between 1999 and 2018, with a biopsy-proven proliferative LN (class III/IV) and who attained CRR (proteinuria <0.5g/day and normal renal function, according to EULAR/ERA-EDTA definition) following induction treatment. Only proteinuric flares were considered and defined as doubling of proteinuria to >1g/day. Clinical-analytic characteristics at baseline (time of first CRR attainment after induction) were compared using survival analysis for time-to-flare. Variables with p<0.10 on univariate analysis with Log-Rank tests were further evaluated as predictors with multivariate Cox proportional hazards regression models (Backward Stepwise method, Wald-based), with estimation of hazard ratios (HR) with 95% confidence intervals (95%CI).Results:A total of 50 patients in CRR were included in the analysis (78.4% female, age at baseline 30.0 ± 12.5 years-old). Over the follow-up period, 10 patients (20.0%) experienced a proteinuric flare, within a mean time of 29.1 months (95%CI 26.89-31.37). In univariate analysis, age <30years (p=0.020), arterial hypertension (p=0.020) and presence of anti-RNP antibody (p=0.002) at baseline were associated with higher risk of LN proteinuric flares. In multivariate analysis, age <30 years (HR 26.56; 95%CI 1.93-365.08; p=0.014), arterial hypertension (HR 8.30; 95%CI 1.21-56.92; p=0.031), use of antihypertensive antiproteinuric drugs (angiotensin-converting-enzyme inhibitors or angiotensin receptor blockers) (HR 11.18; 95%CI 1.24-100.66; p=0.031) and maintenance therapy with azathioprine (HR 6.23; 95%CI 1.51-25.66; p=0.011) (Figure 1) were predictors of LN proteinuric flares.Figure 1.Conclusion:In patients with proliferative LN, proteinuric flares are a frequent event after induction treatment leads to CRR. Younger age, arterial hypertension, use of antihypertensive drugs and use of azathioprine as maintenance therapy were risk factors for LN proteinuric flare in this cohort.Disclosure of Interests:Mariana Luis: None declared, Ana Rita Prata: None declared, Helena Assunção: None declared, José Antonio P. da Silva Grant/research support from: Pfizer, Abbvie, Consultant of: Pfizer, AbbVie, Roche, Lilly, Novartis, Luís Inês: None declared

scholarly journals SAT0185 PREDICTORS OF POOR RENAL OUTCOME IN PATIENTS WITH PROLIFERATIVE LUPUS NEPHRITIS: A 36-MONTHS COHORT STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1034.2-1034
Author(s):  
M. Luis ◽  
A. R. Prata ◽  
H. Assunção ◽  
J. A. P. Da Silva ◽  
L. Inês
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Lupus Nephritis ◽  
Induction Therapy ◽  
Antihypertensive Drugs ◽  
Univariate Analysis ◽  
Unmet Need ◽  
Renal Outcome ◽  
Induction Treatment ◽  
Renal Response

Background:The EULAR/ERA-EDTA recommendations for lupus nephritis (LN) state that renal response should be achieved within 12 months following induction therapy. However, there is an unmet need for early predictors of renal outcome in order to adjust the immunosuppression regimen and optimize the renal outcome.Objectives:To identify predictors of poor renal outcome at baseline, 3 months and 6 months after starting induction therapy.Methods:Retrospective cohort study over 36 months including patients with Systemic lupus erythematosus (SLE) fulfilling the ACR’97 and/or the SLICC’12 classification criteria and with biopsy-proven proliferative LN (class III/IV), enrolled in the CHUC Lupus Cohort from 1999 to 2018. Poor renal outcome was defined as longer time to complete renal response (CRR), characterized by proteinuria <0.5g/day and normal renal function, according to EULAR/ERA-EDTA criteria. Clinical-analytical characteristics at baseline, 3 months and 6 months after starting induction treatment were compared using survival analysis for time-to-CRR. Variables with p<0.25 on univariate analysis using Log-Rank tests were further evaluated as predictors applying multivariate Cox proportional hazards regression models (Backward Stepwise method, Wald-based) with estimation of hazard ratios (HR) and 95% confidence intervals (95%CI).Results:56 patients were included (76.8% female, age at LN diagnosis 30.0 ± 13.2 years). Over the follow-up, 51 patients (91.1%) achieved CRR, within a median time of 6.0 months. In multivariate analysis, predictors of poor renal outcome were proteinuria >2g/day at baseline (HR 1.98; 95%CI 1.04-3.77; p=0.037) and induction therapy with pulse cyclophosphamide (CYC), as compared to mycophenolate mofetil (MMF) (HR=2.05; 95%CI 1.07-3.94; p=0.030) (Figure 1). Diabetes mellitus (HR=6.0; 95%CI 1.24-29.07; p=0.026) and negative anti-RNP antibody (HR 3.17; 95%CI 1.27-7.93; p=0.013) at baseline predicted poor renal outcome at 3 months. At this timepoint, level of proteinuria and clearance rate were not predictive of renal response. At 6 months, no predictors of LN outcome were found for those patients that did not achieve CRR up to this timepoint. Use of glucocorticoid pulses and/or antihypertensive drugs did not predict LN outcome.Figure 1.Conclusion:In this SLE cohort, most patients with proliferative LN achieved CRR. Proteinuria above 2 g/day at baseline and diabetes mellitus were predictors of poor renal outcome, while positive anti-RNP was protective. Induction treatment with CYC was associated with poorer outcome as compared with MMF. Given the retrospective non-randomized nature of this study, caution is needed when drawing conclusions regarding both treatments efficacy.Disclosure of Interests:Mariana Luis: None declared, Ana Rita Prata: None declared, Helena Assunção: None declared, José Antonio P. da Silva Grant/research support from: Pfizer, Abbvie, Consultant of: Pfizer, AbbVie, Roche, Lilly, Novartis, Luís Inês: None declared

scholarly journals ARB I olmesartan interruption in cardiovascular and cardiorenal continuum: antihypertensive and nephroprotective effects (part 1)

2014 ◽  
Vol 5 (3-4) ◽  
pp. 32-40
Author(s):  
M. G Bubnova
Keyword(s):  
Arterial Hypertension ◽  
Pharmacological Activity ◽  
Safety Profile ◽  
Antihypertensive Drugs ◽  
Angiotensin Receptor Blockers ◽  
Olmesartan Medoxomil ◽  
Angiotensin Receptor ◽  
Protective Properties ◽  
Receptor Blockers ◽  
Adherence Therapy

The article provides an overview of the efficacy and tolerability of one of the representatives of the class angiotensin receptor blockers II - olmesartan medoxomil (Kardosal). Analyzed are the characteristics and pharmacological activity of olmesartan medoxomil antihypertensive monotherapy, in combination with other antihypertensive drugs, in different groups of patients. The article describes the renal protective properties of the drug, its safety profile. It also discusses the reasons for poor adherence therapy in patients with arterial hypertension.

scholarly journals AB0286 EFFICACY OF MYCOPHENOLATE MOFETIL PLUS RITUXIMAB COMPARED WITH INTRAVENOUS CYCLOPHOSPHAMIDE PLUS RITUXIMAB IN PATIENTS WITH RELAPSING LUPUS NEPHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1169.1-1169
Author(s):  
L. D. Fajardo Hermosillo
Keyword(s):  
Mycophenolate Mofetil ◽  
Lupus Nephritis ◽  
Maintenance Therapy ◽  
Lupus Erythematosus ◽  
Univariate Analysis ◽  
Oral Prednisone ◽  
Normal Serum ◽  
Nephrol Dial Transplant ◽  
Percent Improvement ◽  
The Mean

Background:Lupus nephritis (LN) remaining as one of the most devastating manifestations of systemic lupus erythematosus (SLE). Only 60% of patients with LN achieve a complete (CR) or partial remission (PR) with mycophenolate mofetil (MMF) or intravenous (iv) cyclophosphamide (CY) plus corticosteroids. Of those nearly one-half will have a relapse following maintenance therapy [1]. Rituximab (RTX) is considered a treatment of relapsing LN [2]. Although potential benefits have been revealed in descriptive studies, efficacy has not been established in randomized trials [3,4].Objectives:This study compares the efficacy achieving a CR or PR with MMF+RTX versus iv CY+RTX in patients with relapsing LN.Methods:Mexican SLE patients classified by SLICC 2012 criteria were recruited from 2013 to 2019 with LN diagnosed by renal biopsy who previously having achieved a CR with MMF or iv CY followed by the maintenance therapy with azathioprine (AZA) or MMF and subsequently present relapsing LN consisting of a new active urinary sediment (US), worsening proteinuria and renal function. Demographic, renal clinical and paraclinical variables were examined. All patients received oral prednisone (1 mg/kg/d) accompanying MMF 3 g/d or CY 0.5–1 g/m2 monthly plus RTX 1 g at 0 and 14 days. The data were evaluated at 0, 6, 12 and 24 month(s) after the start both treatments. CR was defined as normal serum creatinine (SCr), inactive US, plus 24-Hour Urine Protein (24hUP) <500 mg/d and PC was established as 50 percent improvement in renal parameters. Fisher’s exact and Student´s-t tests were performed by univariate analysis.Results:Of nine SLE patients with relapsing LN, seven were women. The mean age [standard deviation (SD)] was 25.1 (6.4) years. The mean time at the onset of SLE (SD) was 3.44 (1.12) years ago. Four and five patients had class IV and IV/V LN respectively. Time of relapsing LN after of CR (SD) was 21.2 (7.17) months. Seven patients used CY followed by AZA and two employed MMF previously of relapsing LN. The mean of basal SLEDAI and SLICC (SD) were 19.11(3.2) and 1.22 (0.44) respectively. The mean of basal 24hUP (SD) was 4.67 (2.6) g/d and sCr (SD) was 2.0 (0.84) mg/dl. Five patients used MMF+RTX and four patients utilized CY+RTX. No statistically significant differences were found for CR, PR, 24hUP, sCr, US, anti-dsDNA and complement between both groups. At 6 months one patient achieved a CR and six reached a PR. At 12 months four patients fulfilled a CR and seven had a PR. Finally, at 24 months seven patients showed a CR and a CP. Only two patients did not achieve a CR or PR at 24 months.Conclusion:This study suggests that the most of SLE patients with relapsing LN treated with CY or MMF plus RTX achieved CR or PR at 24 months, although were no found differences between both treatments. However, these observations must be confirmed in larger and prospective studies.References:[1]Ann Rheum Dis 2020;79(6):713;[2]Nephrol Dial Transplant 2019;34(1):22;[3]Clin J Am Soc Nephrol 2009;4(3):579;[4]Arthritis Rheum 2012;64(4):1215Disclosure of Interests:None declared

Mycophenolate as Maintenance Therapy for Lupus Nephritis with Impaired Renal Function

2013 ◽  
Vol 37 (6) ◽  
pp. 509-517 ◽  
Author(s):  
F. Rivera ◽  
M.L. Illescas ◽  
E. López-Rubio ◽  
J. Fulladosa ◽  
R. Poveda ◽  
...  
Keyword(s):  
Renal Function ◽  
Lupus Nephritis ◽  
Maintenance Therapy ◽  
Impaired Renal Function

scholarly journals Antihypertensive Treatment in Kidney Transplant Recipients—A Current Single Center Experience

2020 ◽  
Vol 9 (12) ◽  
pp. 3969
Author(s):  
Ulrich Jehn ◽  
Katharina Schütte-Nütgen ◽  
Markus Strauss ◽  
Jan Kunert ◽  
Hermann Pavenstädt ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Kidney Transplant ◽  
Antihypertensive Treatment ◽  
Antihypertensive Drugs ◽  
Angiotensin Receptor Blockers ◽  
Antihypertensive Agents ◽  
Kidney Graft ◽  
Allograft Survival ◽  
Ischemic Time ◽  
Cardiovascular Morbidity And Mortality

Arterial hypertension affects the survival of the kidney graft and the cardiovascular morbidity and mortality of the recipient after kidney transplantation (KTx). Thus, antihypertensive treatment is necessary for a vast majority of these patients. Long-term data on antihypertensive drugs and their effects on allograft function after KTx is still limited, and further investigation is required. We retrospectively analyzed a cohort of 854 recipients who received a kidney transplant at our transplant center between 2007 and 2015 with regard to antihypertensive treatment and its influence on graft function and survival. 1-y after KTx, 95.3% patients were treated with antihypertensive therapy. Of these, 38.6% received mono- or dual-drug therapy, 38.0% received three to four drugs and 8.1% were on a regimen of ≥5 drugs. Beta-blockers were the most frequently used antihypertensive agents (68.1%). Neither the use of angiotensin-converting enzyme inhibitor/angiotensin receptor blockers (51.9%) and calcium channel blockers (51.5%), nor the use the use of loop diuretics (38.7%) affected allograft survival. Arterial hypertension and the number of antihypertensive agents were associated with unfavorable allograft outcomes (each p < 0.001). In addition to the well-known risk factors of cold ischemic time and acute rejection episodes, the number of antihypertensive drugs after one year, which reflects the severity of hypertension, is a strong predictor of unfavorable allograft survival.

scholarly journals SAT0186 DEVELOPING PREDICTORS OF GLOBAL BILAG TREATMENT RESPONSE IN PATIENTS WITH LUPUS NEPHRITIS: MORE LESSONS FROM THE ASPREVA LUPUS MANAGEMENT STUDY GROUP (ALMS) DATA

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1034.1-1035
Author(s):  
S. Mcdonald ◽  
S. Yiu ◽  
L. Su ◽  
C. Gordon ◽  
N. Solomons ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Clinical Response ◽  
Treatment Response ◽  
Prediction Models ◽  
Univariate Analysis ◽  
Induction Treatment ◽  
Research Support ◽  
Sledai Score ◽  
Predictors Of Response ◽  
Logistic Regressions

Background:Lupus Nephritis (LN) occurs in up to 60% of patients with SLE and is often associated with other organ involvement, morbidity and mortality. Treatment response and clinical improvement rates are limited with conventional therapy. Little is known about clinical predictors of response in SLE overall or in LN.The ALMS induction trial compared mycophenolate mofetil (MMF) to IV cyclophosphamide (CYC) as induction for LN. MMF was deemed non-superior. The ALMS maintenance trial randomised responders to induction treatment at 6 months to MMF or Azathioprine, with MMF superior during follow-up.Objectives:To identify predictors of overall clinical response at 6 and 12 months, in a cohort of SLE patients with LN.Methods:Using the ALMS trial cohort, we analysed predictors of response in all the patients as a single cohort. ‘Classic’ BILAG scores were used to assess organ responses over time. Endpoints analysed were:1) Improvement: defined as reduction in BILAG score to ≤ one BILAG B and no new BILAG organ domains involved, no increase in steroids from baseline and no increase in SLEDAI from baseline.2) Major Clinical Response (MCR): defined as reduction in BILAG score to BILAG C in all domains, a reduction in steroid dose to ≤ 7.5mg daily and a SLEDAI score ≤ 4.Potential predictors examined included baseline demographics, medication, disease activity (BILAG, SLEDAI), SLICC/ACR damage index (SDI) and serology. Univariate logistic regressions were used to provide odds ratios of predictors. Multivariate logistic regressions with LASSO and cross-validation in randomly split samples were utilised to build prediction models. Predictors were ranked by the percentage of times they were selected by LASSO.Results:370 patients enrolled in the ALMS induction trial. 227 patients were randomised at 6 months to maintenance. 313(84.59%) patients were female. 147(39.72%) patients were Caucasian. The mean age was 31.9 years. 236(63.78%) patients had a disease duration of LN of < 1 year. Baseline mean(± SD) SLEDAI score was 15.28 (±6.78) and mean(± SD) numerical BILAG score was 19.61(±7.67).Improvement at 6 months was attained by 180 (48.65%). Predictors included older age (OR=1.03 [95% CI: 1.01,1.05] per year) and normal haemoglobin (OR=1.90 [95% CI: 1.19, 3.05] vs low hb). Activity (BILAG A or B) in haematological and mucocutaneous domains predicted less improvement (OR [95% CI] = 0.59 [95% CI: 0.38, 0.94] and 0.50 [95% CI: 0.31,0.82] respectively). Baseline damage (SDI >1) negatively predicted improvement (OR 0.54 [95% CI: 0.31,0.92]).Improvement at 12 months was acheived by 139 (37.57%). Low IgG predicted improvement (OR 4.66 [95% CI: 1.34,16.23]. Black US patients were less likely to improve (OR 0.29 [95% CI: 0.06,0.90] vs Asian patients).MCR was achieved by 14(3.79%) and 40(10.81%) at 6 and 12 months. We found regional and racial differences in 12-month MCR responses (Figure 1). Baseline normal C4 predicted a decreased likelihood of MCR (OR 0.37 [95% CI: 0.17,0.64] vs normal C4).Figure 1.Univariate analysis of Improvement at 6 and 12 months and MCR at 12 months.Results of multivariate logistic regression with LASSO were consistent with the univariate analyses.Conclusion:A number of factors were related to improvement and MCR in conventionally treated LN patients. Those with damage and active non-renal disease were less likely to improve at 6 months. Baseline low C4 increased MCR likelihood at 12 months. These factors may help stratify patients based on likelihood of response and help select patients who may need alternative treatment strategies.Disclosure of Interests:Stephen McDonald: None declared, Sean Yiu: None declared, Li Su: None declared, Caroline Gordon Grant/research support from: UCB, Consultant of: UCB, BMS, EMD Serono, Speakers bureau: UCB, Neil Solomons Shareholder of: Aurinia Pharmaceuticals, Inc. stock, Employee of: Employed currently by Aurinia PharmaceuticalsPrevious employee of Aspreva Pharmaceuticals, Ian N. Bruce Grant/research support from: Genzyme Sanofi, GSK, and UCB, Consultant of: Eli Lilly, AstraZeneca, UCB, Iltoo, and Merck Serono, Speakers bureau: UCB

Fixed combination in patients with arterial hypertension: focus on antihypertensive and nephroprotective properties of fixed combination of lisinopril and amlodipine (clinical example)

2020 ◽  
pp. 19-28
Author(s):  
E. Yu. Ebzeeva ◽  
O. D. Ostroumova ◽  
N. M. Doldo ◽  
E. E. Pavleeva
Keyword(s):  
Kidney Disease ◽  
Arterial Hypertension ◽  
Fixed Combination ◽  
Enzyme Inhibitor ◽  
Antihypertensive Drugs ◽  
Adult Population ◽  
Secondary Damage ◽  
Dihydropyridine Calcium Channel Blocker ◽  
Based Medicine ◽  
Modern Population

Arterial hypertension (AH) remains one of the most significant medical and social problems in the world, its prevalence among the adult population is 30–45%. Along with this, the modern population is characterized by a high incidence of chronic kidney disease (CKD), including due to their secondary damage in the framework of hypertension. In turn, CKD is an important independent risk factor for the development and progression of cardiovascular diseases, including fatal ones. The use of existing approaches to nephroprotection in the treatment of patients with hypertension will significantly improve the prognosis both in patients with risk factors for developing renal dysfunction and in patients with pre-existing kidney disease. According to current recommendations for hypertension in such clinical situations, therapy should begin with fixed combinations of antihypertensive drugs. The combination of an angiotensin converting enzyme inhibitor (ACE) and a dihydropyridine calcium channel blocker (CCВ) demonstrated the greatest effectiveness according to evidence-based medicine in patients with high-risk hypertension, including from the standpoint of nephroprotection. In the presented clinical case, the successful use of a fixed combination of ACE and CCВ in a patient with hypertension and microalbuminuria is described.

The JPJDF has Synergistic Effect with Fluoropyrimidine in the Maintenance Therapy for Metastatic Colorectal Cancer

2020 ◽  
Vol 15 (3) ◽  
pp. 257-269
Author(s):  
Xiaoling Fu ◽  
Yanbo Zhang ◽  
Lisheng Chang ◽  
Dengcheng Hui ◽  
Ru Jia ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Synergistic Effect ◽  
Maintenance Therapy ◽  
Metastatic Colorectal Cancer ◽  
Maintenance Treatment ◽  
Advanced Colorectal Cancer ◽  
Treated Group ◽  
Induction Treatment ◽  
Chemotherapeutic Regimen ◽  
Significant Difference

Background: Maintenance chemotherapeutic regimen with low toxicity is needed for metastatic colorectal cancer. A recent patent has been issued on the spleen-strengthening and detoxification prescription (JPJDF), a traditional Chinese herbal medicinal formula with anti-angiogenesis effect. The clinical effect of JPJDF on the maintenance treatment of advanced colorectal cancer has not been evaluated. Objective: This study aims to evaluate the effectiveness and safety of JPJDF in combination with fluoropyrimidine compared to fluoropyrimidine alone as maintenance therapy for metastatic colorectal cancer. Methods: We applied a prospective, randomized, double-blinded, single center clinical study design. A total of 137 patients with advanced colorectal cancer were recruited. Patients received either Fluoropyrimidine (Flu-treated group, n = 68), or Fluoropyrimidine plus JPJDF (Flu-F-treated group, n = 69) as maintenance treatment after 6-cycle of FOLFOX4 or FOLFORI induction treatment. The primary endpoints were Progression-Free Survival (PFS) and Overall Survival (OS). The secondary endpoints were safety, Performance Status (PS) score and other symptoms. Results: The endpoint of disease progression was observed in 91.7% of patients. The PFS was 5.0 months and 3.0 months in the Flu-F-treated and Flu-treated groups, respectively. The OS was 15.0 months and 9.0 months in the Flu-F-treated and Flu-treated groups, respectively. Some common symptoms, such as hypodynamia, anepithymia, dizziness and tinnitus and shortness of breath, were improved in the Flu-F-treated group. There was no significant difference in the common adverse reactions between the two groups. Conclusion: JPJDF and fluoropyrimidine have synergistic effect in the maintenance treatment of mCRC.

Predictors of Faster Decline of Residual Renal Function in Taiwanese Peritoneal Dialysis Patients

2008 ◽  
Vol 28 (3_suppl) ◽  
pp. 191-195 ◽  
Author(s):  
Chia-Te Liao ◽  
Chih-Chung Shiao ◽  
Jenq-Wen Huang ◽  
Kuan-Yu Hung ◽  
Hsueh-Fang Chuang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Renal Function ◽  
Peritoneal Dialysis ◽  
Clinical Laboratory ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Residual Renal Function ◽  
Measure Data ◽  
Chi Square ◽  
Artery Disease

⋄ Objective Loss of residual renal function (RRF) in peritoneal dialysis (PD) patients is a powerful predictor of mortality. The present study was conducted to determine the predictors of faster decline of RRF in PD patients in Taiwan. ⋄ Methods The study enrolled 270 patients starting PD between January 1996 and December 2005 in a single hospital in Taiwan. We calculated RRF as the mean of the sum of 24-hour urea and creatinine clearance. The slope of the decline of residual glomerular filtration rate (GFR) was the main outcome measure. Data on demographic, clinical, laboratory, and treatment parameters; episodes of peritonitis; and hypotensive events were analyzed by Student t-test, Mann–Whitney U-test, and chi-square, as appropriate. All variables with statistical significance were included in a multivariate linear regression model to select the best predictors ( p < 0.05) for faster decline of residual GFR. ⋄ Results All patients commencing PD during the study period were followed for 39.4 ± 24.0 months (median: 35.5 months). The average annual rate of decline of residual GFR was 1.377 ± 1.47 mL/min/m2. On multivariate analysis, presence of diabetes mellitus ( p < 0.001), higher baseline residual GFR ( p < 0.001), hypotensive events ( p = 0.001), use of diuretics ( p = 0.002), and episodes of peritonitis ( p = 0.043) independently predicted faster decline of residual GFR. Male sex, old age, larger body mass index, and presence of coronary artery disease or congestive heart failure were also risk factors on univariate analysis. ⋄ Conclusions Our results suggested that diabetes mellitus, higher baseline residual GFR, hypotensive events, and use of diuretics are independently associated with faster decline of residual GFR in PD patients in Taiwan.

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