scholarly journals Plasma fibrinogen as a predictor of residual renal function in patients undergoing peritoneal dialysis

2021 ◽  
Author(s):  
Ling Qi ◽  
Peipei Huang ◽  
Xiaoping Wang ◽  
Shan Zhu ◽  
Xiaomei Wang ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Risk Model ◽  
Independent Predictor ◽  
Inflammatory Marker ◽  
Linear Regression Analysis ◽  
Reduction Rate ◽  
Residual Renal Function ◽  
Plasma Fibrinogen ◽  
Control Group

Abstract Background： Inflammatory markers are powerful predictors of prognosis in patients undergoing peritoneal dialysis (PD). Plasma fibrinogen (FIB), an inflammatory marker, is considered an independent predictor of cardiovascular events and mortality in PD patients. However, little is known about the association between FIB and residual renal function (RRF) in PD patients. Material/Methods: We reviewed the clinical data of patients who started PD between January 2012 and December 2020 at the First Affiliated Hospital of Wenzhou Medical University. This study covered 472 patients in total. Residual renal function (RRF) was determined by a 24-hour urine collection and calculated from the average of creatinine and urea clearance. Clinical and biochemical data at the initiation of peritoneal dialysis was collected as baseline data. Results: The median follow-up duration was 31.55 (20.43-49.00) months. The RRF reduction rate was significantly greater in patients in the high-fibrinogen group (fibrinogen >4.0 g/L) compared with those in the control group (fibrinogen ≤4.0 g/L; 0.13 ± 0.15 mL/min/month/1.73m2 vs. 0.088 ± 0.10 mL/min/month/1.73m2; p<0.001). Using multiple linear regression analysis and adjusting for other risk factors, high FIB was an independent predictor of rapid RRF decline (P=0.033). The Cox proportional hazard model and the competing risk model revealed that an elevated plasma FIB level (HR=1.219, 95%CI 1.058-1.404; SHR=1.154, 95%CI 1.012-1.317) was independent factors for the progression to anuria. Conclusions: We demonstrated that a higher plasma fibrinogen level was significantly associated with a higher rate of RRF decline, and hyperfibrinogenemia was an independent risk factor for anuria in PD patients.

scholarly journals Effects of ACEIs and ARBs on the Residual Renal Function in Peritoneal Dialysis Patients: A Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Lei Ding ◽  
Jingjuan Yang ◽  
Lizhu Li ◽  
Yi Yang
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Randomized Controlled Trials ◽  
Active Control ◽  
Meta Analysis ◽  
Residual Renal Function ◽  
Control Group ◽  
Controlled Trials ◽  
Active Control Group ◽  
Randomized Controlled

Background. In peritoneal dialysis (PD) patients, whether angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) could protect residual renal function is still controversial. To assess the effects of ACEIs and ARBs on the residual renal function and cardiovascular (CV) events in peritoneal dialysis patients, we performed a meta-analysis of randomized controlled trials. Materials and Methods. We searched PubMed, EMBASE, the Cochrane Library, the CNKI database, and the Wanfang database for relevant articles from database inception to November 30, 2019. Randomized controlled trials were included. The primary outcome was the decline in the residual renal function (RRF). Results. Thirteen trials with 625 participants were included in the meta-analysis. The average residual GFR declined by 1.79 ml/min per 1.73 m2 in the ACEI/ARB group versus 1.44 ml/min per 1.73 m2 in the placebo or active control group at 3 mo. The average residual GFR declined by 2.02 versus 2.06, 2.16 versus 2.72, and -0.04 versus 2.74 ml/min per 1.73 m2 in the placebo or active control group at 6 months (mo), 12 mo, and 24 mo, respectively. The decline in residual GFR showed a significant difference between the ACEI/ARB group and the placebo or active control group at 12 mo (MD=−0.64 ml/min per 1.73 m2; 95% CI: -0.97~-0.32; I2=44%; P<0.0001). No significant difference was observed in Kt/V, urinary protein excretion, weekly creatinine clearance, CV events, or serum potassium levels. Conclusions. In the present study, we found that the use of ACEIs and ARBs, especially long-term treatment, decreased the decline of RRF in patients on PD. ACEIs and ARBs do not cause an additional risk of side effects.

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.

Nutritional Status of Capd Patients at Three Years

1996 ◽  
Vol 16 (1_suppl) ◽  
pp. 195-204 ◽  
Author(s):  
Leocadia Palop ◽  
Nicanor Vega ◽  
Teresa Rodriguez ◽  
Ana Fernandez ◽  
Jose C. Rodriguez ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Steady State ◽  
Nutritional Status ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Nutritional Assessment ◽  
Residual Renal Function ◽  
Control Group ◽  
Protein Calorie Malnutrition

A nutritional assessment was carried out in 63 patients starting treatment from April 1990 up to December 1993. Anthropometric measurements were performed showing a prevalence of protein-calorie malnutrition (PCM) of 21 % in a total of 142 clinical surveys carried out in the above-mentioned sample. A steady state of albumin levels in plasma was verified during a three-year follow-up period at a lower level than that of the control group. The patients’ lymphocytic profile throughout the study was characterized by lymphopenia and decreased B and T 8 lymphocytes. During the first two years of continuous ambulatory peritoneal dialysis (CAPD), a high percentage of patients met the “adequacy” dialysis criteria as residual renal function plays an important role as regards treatment.

Residual renal function (RRF) is an independent predictor of mortality in peritoneal dialysis (PD) patients (PTS)

2001 ◽  
Vol 37 (4) ◽  
pp. A23
Author(s):  
Bhavani Mahankali ◽  
Paul A. Fein ◽  
Krishnan Babu ◽  
Rajanna Sreedhara ◽  
Regina Lilly ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Independent Predictor ◽  
Residual Renal Function

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.

scholarly journals A Pilot Study Examining the Effects of Tolvaptan on Residual Renal Function in Peritoneal Dialysis for Diabetics

2015 ◽  
Vol 35 (5) ◽  
pp. 552-558 ◽  
Author(s):  
Takeyuki Hiramatsu ◽  
Akinori Hobo ◽  
Takahiro Hayasaki ◽  
Koki Kabu ◽  
Shinji Furuta
Keyword(s):  
Diabetes Mellitus ◽  
Renal Function ◽  
Peritoneal Dialysis ◽  
Pilot Study ◽  
Atrial Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Residual Renal Function ◽  
Volume Control ◽  
Control Group ◽  
Atrial Natriuretic

BackgroundFor patients with end-stage renal disease (ESRD), peritoneal dialysis (PD) serves as a possible renal replacement therapy. However, most PD patients, particularly those with ESRD and diabetes mellitus, reportedly discontinue PD early, resulting in shorter survival periods and poorer prognosis because of overhydration. Recently, the vasopressin-2 receptor antagonist tolvaptan was approved for volume control in patients with heart failure. The present study aimed to identify the effects of tolvaptan in diabetic PD patients.MethodsIn this pilot study, the tolvaptan group ( n = 12) were treated with 15 mg/day of tolvaptan 2 weeks after PD initiation and were prospectively analyzed for 1 year, and patients in the control group ( n = 12) did not receive tolvaptan and were retrospectively analyzed for 1 year. In addition to the biochemical tests, echocardiograms, serum atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) levels, peritoneal Kt/V, and creatinine clearance (CCr) were examined at baseline and at 6 and 12 months after PD initiation.ResultsIn the control group, the urine volume, renal Kt/V, and renal CCr levels consistently decreased; however, these parameters were stably maintained during the study period in the tolvaptan group. Atrial natriuretic peptide, CRP levels and the left ventricular mass index of the tolvaptan-treated group were significantly lower than those in the control group, whereas total protein and albumin levels were significantly higher at 6 and 12 months in the tolvaptan group. There were no obvious adverse effects.ConclusionsThese data suggest that tolvaptan may preserve residual renal function and improve volume control in PD patients with diabetes mellitus.

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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