Clinical characteristics associated with the properties of gut microbiota in peritoneal dialysis patients

2020 ◽  
pp. 089686082097698
Author(s):  
Na Jiang ◽  
Chenhong Zhang ◽  
Hao Feng ◽  
Jiangzi Yuan ◽  
Li Ding ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Gut Microbiota ◽  
Clinical Characteristics ◽  
High Throughput Sequencing ◽  
Residual Renal Function ◽  
Microbial Composition ◽  
Cross Sectional ◽  
Dialysis Duration ◽  
Glucose Exposure

Background: Gut microbiota alters in patients with end-stage renal disease, which contributes to inflammation, atherosclerosis, and results in increased incidence of cardiovascular diseases. The present study investigated the potential clinical factors, which influence the gut microbial structure and function in patients undergoing peritoneal dialysis (PD). Methods: This is a cross-sectional study performed in 81 prevalent PD patients. Gut microbiota was assessed by high throughput sequencing of 16S ribosomal ribonucleic acid gene in fecal samples. Gas chromatography was conducted to measure stool short-chain fat acid (SCFA) concentrations. Demographic parameters and clinical characteristics, including dialysis regimen, residual renal function, nutrition, and inflammation, were retrieved and related to the properties of gut microbiota. Results: PD duration, peritoneal glucose exposure, and estimated glomerulus filtration rate (eGFR) were identified to be associated with microbial variations. Significant separation of microbial composition was shown between patients with short or long PD duration ( p = 0.015) and marginal differences were found between patients grouped by different levels of peritoneal glucose exposure ( p = 0.056) or residual renal function ( p = 0.063). A couple of gut bacteria showed different abundance at amplicon sequencing variant level between these patient groups ( p < 0.05). In addition, stool isobutyric and isovaleric acid concentrations were significantly reduced in patients with longer dialysis duration, higher peritoneal glucose exposure, or declined eGFR ( p < 0.05). Conclusions: This pilot study demonstrated that long dialysis duration, high peritoneal glucose exposure, and loss of residual renal function were associated with gut microbiota alteration and reduced branched-chain SCFA production in PD patients.

Predictors of Residual Renal Function Decline in Peritoneal Dialysis Patients: ThebalANZ Trial

2017 ◽  
Vol 37 (3) ◽  
pp. 283-289 ◽  
Author(s):  
Htay Htay ◽  
Yeoungjee Cho ◽  
Elaine M. Pascoe ◽  
Darsy Darssan ◽  
Carmel Hawley ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Demographic Data ◽  
Urine Volume ◽  
Renin Angiotensin System ◽  
Residual Renal Function ◽  
Angiotensin System ◽  
Low Glucose ◽  
Glucose Exposure

ObjectivePreservation of residual renal function (RRF) is associated with improved survival. The aim of the present study was to identify independent predictors of RRF and urine volume (UV) in incident peritoneal dialysis (PD) patients.MethodsThe study included incident PD patients who were balANZ trial participants. The primary and secondary outcomes were RRF and UV, respectively. Both outcomes were analyzed using mixed effects linear regression with demographic data in the first model and PD-related parameters included in a second model.ResultsThe study included 161 patients (mean age 57.9 ± 14.1 years, 44% female, 33% diabetic, mean follow-up 19.5 ± 6.6 months). Residual renal function declined from 7.5 ± 2.9 mL/min/1.73 m2at baseline to 3.3 ± 2.8 mL/min/1.73 m2at 24 months. Better preservation of RRF was independently predicted by male gender, higher baseline RRF, higher time-varying systolic blood pressure (SBP), biocompatible (neutral pH, low glucose degradation product) PD solution, lower peritoneal ultrafiltration (UF) and lower dialysate glucose exposure. In particular, biocompatible solution resulted in 27% better RRF preservation. Each 1 L/day increase in UF was associated with 8% worse RRF preservation ( p = 0.007) and each 10 g/day increase in dialysate glucose exposure was associated with 4% worse RRF preservation ( p < 0.001). Residual renal function was not independently predicted by body mass index, diabetes mellitus, renin angiotensin system inhibitors, peritoneal solute transport rate, or PD modality. Similar results were observed for UV.ConclusionsCommon modifiable risk factors which were consistently associated with preserved RRF and residual UV were use of biocompatible PD solutions and achievement of higher SBP, lower peritoneal UF, and lower dialysate glucose exposure over time.

Risk factors for loss of residual renal function in children with end-stage renal disease undergoing automatic peritoneal dialysis

2020 ◽  
Vol 40 (4) ◽  
pp. 368-376
Author(s):  
Qian Shen ◽  
XiaoYan Fang ◽  
YiHui Zhai ◽  
Jia Rao ◽  
Jing Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Function ◽  
Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Urine Volume ◽  
Residual Renal Function ◽  
Daily Urine ◽  
Glucose Exposure ◽  
Stage Renal Disease ◽  
End Stage

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.

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.

scholarly journals Predictors of Residual Renal Function Decline in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

2015 ◽  
Vol 35 (2) ◽  
pp. 180-188 ◽  
Author(s):  
Cheuk-Chun Szeto ◽  
Bonnie Ching-Ha Kwan ◽  
Kai-Ming Chow ◽  
Sebastian Chung ◽  
Vincent Yu ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Average Rate ◽  
Prognostic Indicator ◽  
Residual Renal Function ◽  
Cox Proportional Hazard ◽  
Gfr Decline ◽  
Glucose Exposure ◽  
Increase In Risk

BackgroundResidual renal function (RRF) is an important prognostic indicator in continuous ambulatory peritoneal dialysis (CAPD) patients. We determined the predictors of RRF loss in a cohort of incident CAPD patients.MethodsWe reviewed the record of 645 incident CAPD patients. RRF loss is represented by the slope of decline of residual glomerular filtration rate (GFR) as well as the time to anuria.ResultsThe average rate of residual GFR decline was -0.083 ± 0.094 mL/min/month. The rate of residual GFR decline was faster with a higher proteinuria (r = -0.506, p < 0.0001) and baseline residual GFR (r = -0.560, p < 0.0001). Multivariate analysis showed that proteinuria, baseline residual GFR, and the use of diuretics were independent predictors of residual GFR decline. Cox proportional hazard model showed that proteinuria, glucose exposure, and the number of peritonitis episodes were independent predictors of progression to anuria, while a higher baseline GFR was protective. Each 1 g/day of proteinuria is associated with a 13.2% increase in the risk of progressing to anuria, each 10 g/day higher glucose exposure is associated with a 2.5% increase in risk, while each peritonitis episode confers a 3.8% increase in risk.ConclusionsOur study shows that factors predicting the loss of residual solute clearance and urine output are different. Proteinuria, baseline residual GFR, and the use of diuretics are independently related to the rate of RRF decline in CAPD patients, while proteinuria, glucose exposure, and the number of peritonitis episodes are independent predictors for the development of anuria. The role of anti-proteinuric therapy and measures to prevent peritonitis episodes in the preservation of RRF should be tested in future studies.

scholarly journals Association of Urinary Dickkopf-3 with Residual Renal Function Decline in Patients Undergoing Peritoneal Dialysis

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 631
Author(s):  
Kenta Torigoe ◽  
Kumiko Muta ◽  
Kiyokazu Tsuji ◽  
Ayuko Yamashita ◽  
Miki Torigoe ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Clinical Characteristics ◽  
Multivariate Analyses ◽  
Residual Renal Function ◽  
Annual Rate ◽  
Renal Survival ◽  
Renal Function Decline ◽  
Urinary Levels ◽  
The Relationship

Background and Objectives: Urinary levels of dickkopf-3 (DKK-3) are associated with poor renal survival in patients with non-dialytic chronic kidney disease. However, it remains unknown whether urinary DKK-3 levels can predict residual renal function (RRF) decline in patients undergoing peritoneal dialysis (PD). Therefore, we investigated the correlation between urinary levels of DKK-3 and the subsequent rate of RRF decline in PD patients. Materials and Methods: This study included 36 PD patients who underwent multiple peritoneal equivalent tests during 2011–2021. The relationship between baseline clinical characteristics and the subsequent annual rate of Kt/V decline was investigated. Results: The annual rate of renal Kt/V decline was 0.29 (range: 0.05–0.48), which correlated with renal Kt/V (r = 0.55, p = 0.0005) and 24 h urinary DKK-3 excretion (r = 0.61, p < 0.0001). Similarly, 24 h urinary DKK-3 excretion (β = 0.44, p = 0.0015) and renal Kt/V (β = 0.38, p = 0.0059) were independently associated with the annual rate of renal Kt/V decline in multivariate analyses. Conclusions: Urinary DKK-3 assessment may help identify PD patients at a high risk of RRF decline.

scholarly journals Reduced Residual Renal Function is Associated with Endothelial Dysfunction in Patients Receiving Peritoneal Dialysis

2012 ◽  
Vol 32 (2) ◽  
pp. 149-158 ◽  
Author(s):  
Seung Hyeok Han ◽  
Sang Choel Lee ◽  
Ea Wha Kang ◽  
Jung Kyung Park ◽  
Hyang Sook Yoon ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Endothelial Dysfunction ◽  
Endothelial Function ◽  
Reactive Hyperemia ◽  
Linear Regression Analysis ◽  
Residual Renal Function ◽  
Multivariate Linear Regression Analysis ◽  
Cross Sectional ◽  
Esrd Patients

♦BackgroundEndothelial dysfunction, which contributes to atherosclerosis and arteriosclerosis, commonly accompanies end-stage renal disease (ESRD). However, little is known about the role of residual renal function (RRF) in endothelial protection in ESRD patients. This study aimed to investigate the relationship between endothelial function and RRF in patients undergoing peritoneal dialysis (PD).♦MethodsThis was a cross-sectional study involving 72 prevalent PD patients. Demographic and clinical data were recorded and residual glomerular filtration rate (GFR), Kt/V urea, and serum concentrations of inflammatory markers were measured. Endothelial function was assessed by brachial artery endothelium-dependent vasodilation [flow-mediated dilation (FMD)] to reactive hyperemia following 5 minutes of forearm ischemia.♦ResultsIn patients with FMD% above the median value (FMD > 2.41%), residual GFR was significantly higher compared to that in patients with FMD% below the median [1.50 (0 - 9.64) vs 0.48 (0 - 3.89) mL/min/1.73 m2, P = 0.026]. Correlation analyses revealed that residual GFR (p = 0.381, P = 0.001) and total Kt/V urea (γ= 0.408, P < 0.001) were positively correlated with FMD%, whereas PD duration (γ = -0.351, P = 0.003), high-sensitivity C-reactive protein (p = -0.345, P = 0.003), pulse pressure (γ = -0.341, P = 0.003), and age (γ = -0.403, P < 0.001) were inversely correlated with FMD%. In contrast, there was no correlation between peritoneal Kt/V urea and FMD%. In multivariate linear regression analysis adjusted for these factors, residual GFR was found to be an independent determinant of FMD% (β = 0.317, P = 0.017).♦ ConclusionThis study shows that RRF is independently associated with endothelial dysfunction in ESRD patients on PD, suggesting that RRF may contribute to endothelial protection in these patients.

MO692COULD THE RESIDUAL RENAL FUNCTION REMAIN A KEY DETERMINANT OF PLASMA OXALIC ACID CONCENTRATION IN PERITONEAL DIALYSIS PATIENTS?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Natalia Stepanova ◽  
Lesya Korol ◽  
Lyudmyla Snisar ◽  
Larysa Lebid
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Residual Renal Function ◽  
Oxalate Oxidase ◽  
Dialysis Patients ◽  
Cross Sectional ◽  
Main Method ◽  
Physiological Conditions ◽  
Oxalate Transport

Abstract Background and Aims Under physiological conditions, the bulk of circulating oxalate (90% to 95%) is ultimately excreted by the kidneys. Under uremic and/or anuric conditions, dialysis is considered to be the main method of oxalate removal. Nevertheless, little evidence is available on oxalate balance in peritoneal dialysis (PD) patients. The present study aimed to evaluate the separate contribution of residual renal and peritoneal oxalate clearances to oxalate balance in PD patients. Method We performed a cross-sectional observational study involving 62 PD patients with the average age of 50.5±13.5 years and PD vintage of 37±24 months. Plasma oxalate (POx) concentration, levels of daily urinary (UOx) and peritoneal dialysis effluent oxalate (PDEOx) excretion were evaluated. POx concentration was measured spectrophotometrically using MAK315 kit (Sigma, Spain); UOx and PDEOx concentrations were determined using an oxalate oxidase/peroxidase reagent (BioSystems, Spain). In addition, oxalate transport status (4-hour D/P oxalate ratio), renal oxalate clearance (ROxCL) and peritoneal oxalate clearance (PerOxCL) were calculated. Results Among the examined PD patients were 41 (66%) patients with preserved diuresis and 21 (34%) patients with anuria. The anuric PD patients had lower PerOxCL and, accordingly, peritoneal and overall oxalate removal levels compared with the patients with preserved diuresis (Table 1). Conclusion The results of our research demonstrated an important role of the residual renal function in oxalate balance in PD patients. However, the decline in RRF could partially (but not completely) contribute to the increase in POx in PD patients. Thus, PerOxCL but not ROxCL could significantly affect oxalate balance 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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