The Association between Baseline Serum Lipids and Mortality in Peritoneal Dialysis Patients

2021 ◽  
pp. 1-10
Author(s):  
Qionghong Xie ◽  
Da Shang ◽  
Yujia Wang ◽  
Min Zhang ◽  
Yun Chen ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Total Cholesterol ◽  
Serum Lipids ◽  
Cox Regression ◽  
Density Lipoprotein ◽  
Residual Renal Function ◽  
Baseline Serum ◽  
All Cause Mortality ◽  
Lower Total Cholesterol

<b><i>Introduction:</i></b> Lipid disturbances are common in ESRD patients. In peritoneal dialysis (PD) patients, dyslipidemia is even more common. This study aimed to examine whether serum lipids were associated with prognosis of PD patients. <b><i>Methods:</i></b> Patients from a multicenter retrospective cohort were used for the present study. The primary endpoint was all-cause mortality. Cox regression was used to analyze the association between serum lipids including total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein, and triglycerides and the prognosis. <b><i>Results:</i></b> The results showed that lower total cholesterol and LDL levels at the initiation of PD predicted higher all-cause mortality in PD patients. Multivariate analysis reveal that the association disappeared after adjusting for age, gender, albumin, prealbumin, protein catabolic rate normalized to body weight, C-reactive protein, and residual renal function. Further analysis showed that patients with lower total cholesterol/LDL had a higher mortality only during the first 24 months of follow-up. In the patients who survived &#x3e;2 years after PD, lower total cholesterol/LDL was not associated with higher long-term all-cause mortality any more. <b><i>Conclusion:</i></b> Lower total cholesterol/LDL levels at the initiation of PD were associated with overall mortality in PD patients. The association could be potentially modified by malnutrition, inflammation, and residual renal function or disappeared after 24 months.

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.

scholarly journals Prognostic Value of Cardiac Troponin T Is Independent of Inflammation, Residual Renal Function, and Cardiac Hypertrophy and Dysfunction in Peritoneal Dialysis Patients

2007 ◽  
Vol 53 (5) ◽  
pp. 882-889 ◽  
Author(s):  
Angela Yee-Moon Wang ◽  
Christopher Wai-Kei Lam ◽  
Mei Wang ◽  
Iris Hiu-Shuen Chan ◽  
William B Goggins ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Cardiac Troponin ◽  
Cardiovascular Events ◽  
Prognostic Value ◽  
Troponin T ◽  
Residual Renal Function ◽  
Cardiovascular Death ◽  
Cardiac Troponin T ◽  
All Cause Mortality

Abstract Background: We investigated whether cardiac troponin T (cTnT) independently predicted outcome and added prognostic value over other clinical risk predictors in chronic peritoneal dialysis (PD) with end-stage renal disease. Methods: Baseline cTnT, echocardiography, indices of dialysis adequacy, and biochemical characteristics were assessed in 238 chronic PD patients who were followed prospectively for 3 years or until death. Results: Using multivariable Cox regression analysis, cTnT remained predictive of all-cause mortality [hazard ratio 4.43, 95% CI 1.87–10.45, P = 0.001], cardiovascular death (4.12, 1.29–13.17, P = 0.017), noncardiovascular death (8.06, 1.86–35.03, P = 0.005), and fatal and nonfatal cardiovascular events (CVEs) (3.59, 1.48–8.70, P = 0.005) independent of background coronary artery disease, inflammation, residual renal function, left ventricular hypertrophy, and systolic dysfunction. cTnT alone had better predictive value than C-reactive protein (CRP) alone for mortality [area under the ROC curve (AUC) 0.774 vs 0.691; P = 0.089] and first CVE (AUC 0.711 vs 0.593; P = 0.009) at 3 years. Survival models including age, sex, and clinical, biochemical, and echocardiographic characteristics yielded AUCs of 0.813 (95% CI, 0.748–0.877), 0.800 (95% CI, 0.726–0.874), and 0.769 (95% CI, 0.708–0.830), respectively, in relation to all-cause mortality, cardiovascular death, and fatal and nonfatal cardiovascular events. After addition of cTnT, AUCs of the above models increased significantly to 0.832 (95% CI, 0.669–0.894; P = 0.0037), 0.810 (95% CI, 0.739–0.883; P = 0.0036), and 0.780 (95% CI, 0.720–0.840; P = 0.0002), respectively; no AUCs increased when CRP was added. Conclusions: cTnT is an independent predictor of long-term mortality, cardiovascular death and events, and noncardiovascular death in PD patients.

scholarly journals Effects of Ginger on Serum Lipids and Lipoproteins in Peritoneal Dialysis Patients: A Randomized Controlled Trial

2016 ◽  
Vol 36 (2) ◽  
pp. 140-145 ◽  
Author(s):  
Hadi Tabibi ◽  
Hossein Imani ◽  
Shahnaz Atabak ◽  
Iraj Najafi ◽  
Mehdi Hedayati ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Peritoneal Dialysis ◽  
Placebo Group ◽  
Total Cholesterol ◽  
Serum Lipids ◽  
Controlled Trial ◽  
Density Lipoprotein ◽  
Serum Triglyceride ◽  
Serum Triglyceride Concentration ◽  
Lipids And Lipoproteins

BackgroundIn peritoneal dialysis (PD) patients, one of the major risk factors for cardiovascular disease is lipid abnormalities. This study was designed to investigate the effects of ginger supplementation on serum lipids and lipoproteins in PD patients.MethodsIn this randomized, double-blind, placebo-controlled trial, 36 PD patients were randomly assigned to either the ginger or the placebo group. The patients in the ginger group received 1,000 mg ginger daily for 10 weeks, while the placebo group received corresponding placebos. At baseline and at the end of week 10, 7 mL of blood were obtained from each patient after a 12- to 14-hour fast, and serum concentrations of triglyceride, total cholesterol, low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), and lipoprotein (a) [Lp (a)] were measured.ResultsSerum triglyceride concentration decreased significantly up to 15% in the ginger group at the end of week 10 compared with baseline ( p < 0.01), and the reduction was significant in comparison with the placebo group ( p < 0.05). There were no significant differences between the 2 groups in mean changes of serum total cholesterol, LDL-C, HDL-C, and Lp (a).ConclusionThis study indicates that daily administration of 1,000 mg ginger reduces serum triglyceride concentration, which is a risk factor for cardiovascular disease, in PD patients.

The Association of Longitudinal Serum Uric Acid and All-Cause Mortality in Incident Peritoneal Dialysis Patients

2018 ◽  
Vol 47 (1-3) ◽  
pp. 185-192 ◽  
Author(s):  
Wenxiu Chang ◽  
Wenyu Zhang ◽  
Xichao Wang ◽  
Ying Liu ◽  
Yingying Han ◽  
...  
Keyword(s):  
Uric Acid ◽  
Peritoneal Dialysis ◽  
Density Lipoprotein ◽  
Residual Renal Function ◽  
Reactive Protein ◽  
All Cause Mortality ◽  
Group 3 ◽  
Group 2 ◽  
Level Group ◽  
Group 1

Background: Time-averaged uric acid (TA-UA) value was calculated to investigate the association of longitudinal UA and all-cause mortality in incident peritoneal dialysis (PD) patients. Methods: Three hundred PD patients were divided into 3 groups based on the serum TA-UA level (Group 1: < 6 mg/dL; Group 2: 6–8 mg/dL; Group 3: ≥8 mg/dL). Hazards ratio (HR) of all-cause mortality was calculated. Logistic regression was conducted to identify the associated clinical factors of lower and higher TA-UA level. Results: Increased HRs for death existed in Group 1 and Group 3 compared with Group 2 (HR 3.24, 95% CI 1.25–8.39, p = 0.016; HR 4.69, 95% CI 1.24–17.72, p = 0.023). Lower residual renal function, lower albumin, and higher high-density lipoprotein cholesterol were related to the lower serum TA-UA. Higher body mass index and higher C-reactive protein were associated with higher serum TA-UA in PD patients. Conclusion: Both TA-UA < 6 and ≥8 mg/dL increased the all-cause mortality in incident PD patients.

The Effect of Depressive Symptoms on Survival in Peritoneal Dialysis Patients

2004 ◽  
Vol 24 (3) ◽  
pp. 256-263 ◽  
Author(s):  
Rebecca Einwohner ◽  
Judith Bernardini ◽  
Linda Fried ◽  
Beth Piraino
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Depressive Symptoms ◽  
Serum Albumin ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Residual Renal Function ◽  
Dialysis Patients ◽  
Single Measurement ◽  
Cox Regression Analysis

Objective There is little information on the relationship between depressive symptoms and survival in peritoneal dialysis (PD) patients. We examined whether a single measurement of depressive symptoms using a simple self-administered tool predicts survival. Design Screening test of depressive symptoms as a predictor of outcome. Setting Three dialysis centers in Southwestern Pennsylvania. Participants 66 adult PD subjects were screened in 1997–1998 for depression using the Zung scale. Main Outcome Measures Baseline data collection included assessments of comorbidity, residual renal function, total Kt/V, nPNA, previous renal transplant, and serum albumin. Outcomes were collected prospectively after completion of the depression survey to 12/01. Cox regression analysis of patient survival was performed using all cofactors with p < 0.05 on univariate analysis. Results One third of patients had depressive symptoms. Compared to nondepressed patients, depressive symptom patients were older (62.5 vs 52.5 years, p = 0.012), had borderline lower serum albumin levels (3.47 vs 3.70 g/dL, p = 0.058), and were more disabled (Karnofsky score 70 vs 90, p < 0.001), but had similar Kt/V, residual renal function, and previous time on PD at the point of the testing. Using multivariate analysis and controlling for comorbidity (using a measurement that includes diabetes mellitus and age) and serum albumin, the survival of patients with depressive symptoms was significantly reduced compared to nondepressed patients. Conclusion A single measurement of depressive symptoms using a simple self-administered test was an independent predictor of death in a cohort of PD patients, which extends observations in hemodialysis patients. Screening for depressive symptoms should be routine for dialysis patients, and those depressed should have thorough assessment and treatment. Whether treating depression will have an impact on survival is unclear and needs to be studied.

scholarly journals Higher Serum Total Cholesterol to High-Density Lipoprotein Cholesterol Ratio Is Associated with Increased Mortality among Incident Peritoneal Dialysis Patients

Nutrients ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 144
Author(s):  
Hee-Won Noh ◽  
Yena Jeon ◽  
Ji-Hye Kim ◽  
Ga-Young Lee ◽  
Soo-Jee Jeon ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Regression Analysis ◽  
Peritoneal Dialysis ◽  
High Density Lipoprotein ◽  
Total Cholesterol ◽  
Body Mass ◽  
High Density Lipoprotein Cholesterol ◽  
Density Lipoprotein ◽  
Cholesterol Ratio ◽  
All Cause Mortality

This study evaluated the association of the serum total cholesterol to high-density lipoprotein cholesterol ratio (TC/HDL-C) with mortality in incident peritoneal dialysis (PD) patients. We performed a multi-center, prospective cohort study of 630 incident PD patients from 2008 to 2015 in Korea. Participants were stratified into quintiles according to baseline TC, HDL-C, LDL-C and TC/HDL-C. The association between mortality and each lipid profile was evaluated using multivariate Cox regression analysis. During a median follow-up period of 70.3 ± 25.2 months, 185 deaths were recorded. The highest TC/HDL-C group had the highest body mass index, percentage of diabetes and serum albumin level. Multivariate analysis demonstrated that the highest quintile of TC/HDL-C was associated with increased risk of all-cause mortality (hazard ratio 1.69, 95% confidence interval 1.04–2.76; p = 0.036), whereas TC, HDL-C and LDL-C were not associated with mortality. Linear regression analysis showed a positive correlation between TC/HDL-C and body mass index. Increased serum TC/HDL-C was an independent risk factor for mortality in the subgroup of old age, female, cardiovascular disease and low HDL-C. The single lipid marker of TC or HDL-C was not able to predict mortality in PD patients. However, increased serum TC/HDL-C was independently associated with all-cause mortality in PD patients.

RESIDUAL RENAL FUNCTION IN PERITONEAL DIALYSIS PATIENTS

2011 ◽  
pp. 30-34
Author(s):  
Hoang Bui Bao Hoang ◽  
Huu Loi Le ◽  
Tam Vo ◽  
Thi Anh Thu Tran
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Close Correlation ◽  
Residual Renal Function ◽  
Central Hospital ◽  
Dialysis Patients

Background: Peritoneal dialysis is used regularlly in treatment of ESRDs. Residual renal function (RRF) in these patients helps the adequacy of PD therapy very much. Objectives: 1. Study RRF of PD patients at Department of Nephro – Rheumatology, Hue Central Hospital. 2. Search the correlation between RRF and Kt/V. Patients and methods: 35 PD patients at Department of Nephro – Rheumatology, Hue Central Hospital. Measure RRF and Kt/V by formulars that depend on blood, urine and PD fluid samples. Results: Mean RRF of PD patients is 4.36 ± 13.8 ml/minute. There is a close correlation between RRF and Kt/V (r=0.79, p<0.01). Conclusion: RRF in PD patients correlates with Kt/V.

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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