scholarly journals Association Between Hypertension and Residual Renal Function in Hemodialysis Patients

2015 ◽  
Vol 13 (2) ◽  
pp. 73-78
Author(s):  
Selma Ajanovic ◽  
Halima Resic ◽  
Fahrudin Masnic ◽  
Aida Coric ◽  
Amela Beciragic ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Residual Renal Function ◽  
Hemodialysis Patients ◽  
Control Group ◽  
Dialysis Patients ◽  
Cardiovascular Morbidity And Mortality ◽  
Number Of Patients ◽  
Negative Linear Correlation ◽  
Residual Diuresis

Abstract Introduction. Cardiovascular diseases are the leading cause of death in hemodialysis patients. The decline of residual renal function increases the prevalence and severity of risk factors of cardiovascular morbidity and mortality in these patients. Hypertension is common in dialysis patients and represents an important independent factor of survival in these patients. Methods. The study included 77 patients who are on chronic HD for longer than 3 months. Depending on the measured residual diuresis patients were divided into two groups. The study group consisted of patients with residual diuresis >250 ml/day, while patients from control group had residual diuresis <250 ml/day. All patients had their blood pressure measured before 10 consecutive hemodialysis treatments. Collected data were statistically analyzed using SPSS 16.0. Results. The study included 77 hemodialysis patients, mean age of 56.56±14.6 years and mean duration of hemodialysis treatment of 24.0 months. Of the total number of patients, 39(50.6%) had preserved residual renal function. Hypertension was more common in the group of patients who did not have preserved residual renal function (68.4% vs 25.6%). There was statistically significant negative linear correlation between the volume of residual urine output and the residual clearance of urea and values of systolic blood pressure [(rho=−0.388; p<0.0001); (rho=−0.392; p<0.0005)], values of mean arterial pressure [(rho =−0.272; p<0.05); (rho=−0.261; p=0.023; p<0.05)] and values of pulse pressure in hemodialysis patients [(rho =−0.387; p<0.001); (rho=−0.400; p<0.0005)]. Conclusions. Residual renal function plays an important role in controlling blood pressure in patients on hemodialysis. More attention should be directed to preserve residual renal function, and after the start of hemodialysis by avoiding intensive ultrafiltration with optimal antihypertensive therapy.

P1180EVOLUTION OF SERUM B2MICROGLOBULIN LEVELS IN INCIDENT PERITONEAL DIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Diego Barbieri ◽  
ANDRÉS FELIPE DELGADO ◽  
Ana García-Prieto ◽  
Almudena Vega ◽  
Soraya Abad Esttebanez ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Cardiovascular Events ◽  
Prospective Observational Study ◽  
Residual Renal Function ◽  
Hemodialysis Patients ◽  
Uremic Toxin ◽  
Dialysis Patients ◽  
Cardiovascular Morbidity And Mortality

Abstract Background and Aims Retention of ß2microglobulin (ß2M), an uremic toxin in the middle molecular range, has been associated with cardiovascular morbidity and mortality in dialysis patients. Although ß2M levels are usually measured in hemodialysis patients, this practice is not common among peritoneal dialysis (PD) patients. The aim of this study is to evaluate the evolution of serum ß2M levels in incident PD patients. Method Prospective, observational study including incident PD patients in our hospital from January 2015 to October 2019. Patients with cardiorrenal syndrome or patients coming from hemodialysis were excluded. Serum ß2M levels were collected before starting PD and during follow up. Weekly KtV, residual renal function and cardiovascular events were also collected during follow up. Results We included 30 patients with a mean age of 57 +/- 17 years. 56.3% were male and 15.6% were diabetic. Mean follow up was 19.8 +/- 16.9 months. 18 patients were on continous ambulatory PD and 12 in automated PD. Mean serum ß2M levels before starting PD were 12.8 +/- 6.6 mg/l and they remained stable during follow up (12.9 +/- 5.2 mg/l, 15 +/- 4.2 mg/l, 14.3 +/- 6.9 mg/l, 10.2+/- 4.5 mg/l at month 6, 12, 24 and 36, respectively; p NS). No differences in serum ß2M levels were observed between continous ambulatory PD and automated PD. Serum ß2M levels were inversely and significantly correlated with weekly KtV (r= -0.943; p 0.009) and residual renal function (r= -0.829; p 0.042). One cardiovascular event was recorded during follow up. Conclusion Serum ß2M levels remain stable during follow up in our cohort of incident PD patients and is significantly and inversely correlated with weekly KtV and residual renal function. Serum ß2M levels monitoring could be helpful in these patients and would yield important information in this population.

scholarly journals Hypertension in peritoneal dialysis patients

2006 ◽  
Vol 59 (3-4) ◽  
pp. 130-134 ◽  
Author(s):  
Mirjana Lausevic ◽  
Natasa Jovanovic ◽  
Ana Bontic ◽  
Biljana Stojimirovic
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Peritoneal Dialysis ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Residual Renal Function ◽  
Dialysis Patients ◽  
Residual Diuresis

Introduction. Continuous ambulatory peritoneal dialysis (CAPD) is effective in reducing blood pressure. Mean arterial pressure falls within 6 months of starting CAPD in the majority of patients. This improved blood pressure control reflects removal of excess fluid volume and body sodium. However, after several years, there is a decline in the efficacy of CAPD in controlling blood pressure. High incidence of hypertension in long-term CAPD patients may be related to hypervolemia as a consequence of loss of residual renal function (RRF), loss of ultrafiltration (UF) due to functional or structural changes in the peritoneal membrane, to a more liberated intake of sodium and fluid, or to administration of erythropoietin. The aim of the present study was to compare the efficacy in blood pressure control in peritoneal dialysis patients depending on the dialysis modality and duration, RRF and dialysis adequacy. Material and methods. This study was a retrospective analysis of 67 patients who attended our Clinic monthly in 2003. All patients received antihy?pertensive therapy (monotherapy-16 pts, two drugs-27 pts, three drugs-22 pts and four-2 pts.). Results. The prevalence of hypertension (TA > 140/90 mmHg) was 73.13%. Most of them (50.75%) had mild hypertension (mean value TA < 160/100 mmHg). There was no statistically significant difference in hypertension prevalence between diabetic (78.27%) and non-diabetic patients (75%). The prevalence of hypertension in patients with residual diuresis of more than 1000 ml was 36.6%, but there were 80.64% patients with residual diuresis less than 500 ml. A statistically significant negative correlation was found between D/DO, UF volume and systolic blood pressure and RRF, D/DO and Ccr and diastolic blood pressure. A statistially significant positive correlation was found between age, body weight, duration of dialysis and systolic blood pressure and age and diastolic blood pressure. Conclusion. We can conclude that duration of PD treatment has a negative effect on blood pressure control. Residual renal function plays an important role in volume and blood pressure control. High and high average transporters are the two groups of patients at increased risk of developing hypertension, especially if they are anuric. .

Risk Factors for Early Mortality in U.S. Peritoneal Dialysis Patients: Impact of Residual Renal Function

2002 ◽  
Vol 22 (3) ◽  
pp. 371-379 ◽  
Author(s):  
◽  
Michael V. Rocco ◽  
Diane L. Frankenfield ◽  
Barbara Prowant ◽  
Pamela Frederick ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Renal Function ◽  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Creatinine Clearance ◽  
Residual Renal Function ◽  
Chronic Peritoneal Dialysis ◽  
Dialysis Patients ◽  
The Mean

Background Potential risk factors for 1-year mortality, including the peritoneal component of dialysis dose, residual renal function, demographic data, hematocrit, serum albumin, dialysate-to-plasma creatinine ratio, and blood pressure, were examined in a national cohort of peritoneal dialysis patients randomly selected for the Centers for Medicare and Medicaid Services End-Stage Renal Disease (ESRD) Core Indicators Project. Methods The study involved retrospective analysis of a cohort of 1219 patients receiving chronic peritoneal dialysis who were alive on December 31, 1996. Results During the 1-year follow-up period, 275 patients were censored and 200 non censored patients died. Among the 763 patients who had at least one calculable adequacy measure, the mean [± standard deviation (SD)] weekly Kt/V urea was 2.16 ± 0.61 and the mean weekly creatinine clearance was 66.1 ± 24.4 L/1.73 m2. Excluding the 365 patients who were anuric, the mean (±SD) urinary weekly Kt/V urea was 0.64 ± 0.52 (median: 0.51) and the mean (±SD) urinary weekly creatinine clearance was 31.0 ± 23.3 L/1.73 m2 (median: 26.3 L/1.73 m2). By Cox proportional hazard modeling, lower quartiles of renal Kt/V urea were predictive of 1-year mortality; lower quartiles of renal creatinine clearance were of borderline significance for predicting 1-year mortality. The dialysate component of neither the weekly creatinine clearance nor the weekly Kt/V urea were predictive of 1-year mortality. Other predictors of 1-year mortality ( p < 0.01) included lower serum albumin level, older age, and the presence of diabetes mellitus as the cause of ESRD, and, for the creatinine clearance model only, lower diastolic blood pressure. Conclusion Residual renal function is an important predictor of 1-year mortality in chronic peritoneal dialysis patients.

The Relationship between Kt/VUrea and Npna in Anuric Peritoneal Dialysis Patients: A Comparison with Predialysis Patients

2001 ◽  
Vol 21 (5) ◽  
pp. 509-515 ◽  
Author(s):  
◽  
Maarten A.M. Jansen ◽  
Johanna C. Korevaar ◽  
Friedo W. Dekker ◽  
Kitty J. Jager ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Residual Renal Function ◽  
Control Group ◽  
Dialysis Patients ◽  
Urea Clearance ◽  
Linear Relationships ◽  
Significant Difference ◽  
Urine Production ◽  
The Relationship

Objective It is unknown whether a given level of urea clearance by the native kidneys provides better or similar control of uremia than the same level of urea clearance by continuous peritoneal dialysis (PD). More insight into possible differences between renal and peritoneal urea clearances is warranted. Therefore, we investigated the relationship between Kt/Vurea and protein equivalent of total nitrogen appearance normalized to body weight (nPNA), the relationship between urea clearance and creatinine appearance, and other nutritional parameters in PD patients without residual renal function, and in predialysis end-stage renal disease patients. Patients All patients participated in the Netherlands Cooperative Study on the Adequacy of Dialysis. This is a prospective cohort study of incident dialysis patients, in whom regular assessments of renal function are done. A group of 75 PD patients was identified at the first follow-up assessment in which their urine production was less than 100 mL/day. These patients were considered the anuric group. This group was compared with a control group of 97 predialysis patients studied 0 – 4 weeks before the start of dialysis treatment. Results Linear relationships were present between Kt/Vurea and nPNA, in both the predialysis patients and the anuric PD patients. A significant difference was present between the slopes of the two regression lines (0.40 vs 0.18, p = 0.007). When Kt/Vurea exceeded 1.3/week, a given level of Kt/Vurea was associated with a higher nPNA in predialysis than in anuric PD patients. Similar relationships were found between Kturea and PNA. Kturea was also significantly related to urine or dialysate creatinine appearance. A significant difference existed between the slopes of the regression lines in the two groups of patients ( p < 0.001). A weekly Kturea of 70 L was associated with a urine creatinine appearance of 11.0 mmol/day and a dialysate creatinine appearance of 8.4 mmol/day. Nutritional status measured with creatinine appearance and Subjective Global Assessment was better in the predialysis population, despite much lower values for Kt/Vurea in these patients. Conclusions The relationship between Kt/Vurea and nPNA in anuric PD patients is different from that in a predialysis population. It follows from our results that, when Kt/Vurea is above 1.3/week, a given level of Kt/Vurea is associated with a higher nPNA in predialysis than in anuric PD patients. This challenges the concept of equivalency between renal and peritoneal Kt/Vurea with respect to control of uremic morbidity.

scholarly journals Pharmacokinetic and Dynamic of Furosemide in Peritoneal Dialysis Patients

2016 ◽  
Vol 36 (1) ◽  
pp. 107-108 ◽  
Author(s):  
Caroline Lamarche ◽  
Maude Pichette ◽  
Denis Ouimet ◽  
Michel Vallée ◽  
Robert Bell ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Peritoneal Dialysis ◽  
Pressure Effect ◽  
Urine Volume ◽  
Residual Renal Function ◽  
Dialysis Patients ◽  
Blood Pressure Effect ◽  
Health Canada

The aim of our study was to evaluate the efficacy and bioavailibility of a commonly used oral furosemide dose (500 mg) compared to a 250 mg intravenous (IV) dose in PD patients with significant residual renal function (urine volume > 100 mL). We also evaluated the immediate blood pressure effect in these patients. The data were obtained from a study we performed for the homologation of a 500-mg dose of furosemide by Health Canada.

scholarly journals FP472INTERACTION OF RESIDUAL RENAL FUNCTION WITH THE EFFECT OF LOW NA SOLUTION ON BLOOD PRESSURE IN PERITONEAL DIALYSIS PATIENTS

2018 ◽  
Vol 33 (suppl_1) ◽  
pp. i195-i196
Author(s):  
Bolesław Rutkowski ◽  
Paul Tam ◽  
Frank van der Sande ◽  
Andreas Vychytil ◽  
Vedat Schwenger ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Peritoneal Dialysis ◽  
Residual Renal Function ◽  
Dialysis Patients

scholarly journals Long‐term blood pressure control in a cohort of peritoneal dialysis patients and its association with residual renal function

2001 ◽  
Vol 16 (11) ◽  
pp. 2207-2213 ◽  
Author(s):  
Murali K. Menon ◽  
David M. Naimark ◽  
Joanne M. Bargman ◽  
Stephen I. Vas ◽  
Dimitrios G. Oreopoulos
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Peritoneal Dialysis ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Residual Renal Function ◽  
Dialysis Patients

scholarly journals Beta-trace protein as a potential biomarker of residual renal function in patients undergoing peritoneal dialysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sebastian Schwab ◽  
Carola Ellen Kleine ◽  
Dominik Bös ◽  
Sylvie Bohmann ◽  
Christian P. Strassburg ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Creatinine Clearance ◽  
Residual Renal Function ◽  
Dialysis Patients ◽  
Potential Biomarker ◽  
Weight Protein ◽  
Low Molecular Weight Protein ◽  
Residual Diuresis

Abstract Background Residual renal function is closely linked to quality of life, morbidity and mortality in dialysis patients. Beta-trace protein (BTP), a low molecular weight protein, has been suggested as marker of residual renal function, in particular in patients on hemodialysis. We hypothesized that BTP also serves as a marker of residual renal function in pertioneal dialysis patients. Methods In this study 34 adult patients on peritoneal dialysis were included. BTP, creatinine, cystatin C and urea concentrations were analyzed simultaneously in serum and dialysate to calculate renal and peritoneal removal of the analytes. Results In peritoneal dialysis patients with residual diuresis, mean serum BTP was 8.16 mg/l (SD ± 4.75 mg/l). BTP correlated inversely with residual diuresis (rs = − 0.58, p < 0.001), residual creatinine clearance (ClCr) (rs = − 0.69, p < 0.001) and total urea clearance (Clurea) (rs = − 0.56, p < 0.001). Mean peritoneal removal of BTP was 3.36 L/week/1.73m2 (SD ± 1.38) and mean renal removal 15.14 L/week/1.73m2 (SD ± 12.65) demonstrating a significant renal contribution to the total removal. Finally, serum BTP inversely correlated with alterations in residual diuresis (r = − 0.41, p = 0.035) and renal creatinine clearance over time (r = − 0.79, p = p < 0.001). Conclusion BTP measurement in the serum may be a simple tool to assess residual renal function in peritoneal dialysis patients.

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