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.

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.

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.

The relationship between the soluble Klotho protein and the residual renal function among peritoneal dialysis patients

2012 ◽  
Vol 16 (3) ◽  
pp. 442-447 ◽  
Author(s):  
Tetsu Akimoto ◽  
Kazuhiro Shiizaki ◽  
Taro Sugase ◽  
Yuko Watanabe ◽  
Hiromichi Yoshizawa ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Residual Renal Function ◽  
Dialysis Patients ◽  
Klotho Protein ◽  
The Relationship

High Peritoneal Clearance of Small Molecules Did Not Provide Low Serum β2–Microglobulin Concentrations in Peritoneal Dialysis Patients

2003 ◽  
Vol 23 (2_suppl) ◽  
pp. 34-36 ◽  
Author(s):  
Suguru Yamamoto ◽  
Akio Kasai ◽  
Hisaki Shimada
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Small Molecules ◽  
Residual Renal Function ◽  
High Flux ◽  
Synthetic Membranes ◽  
Significant Difference ◽  
Continuous Cycling ◽  
Peritoneal Permeability ◽  
The Relationship

Objective Although early reports demonstrated that serum β2-microglobulin (s-β2m) concentrations in patients on peritoneal dialysis (PD) were lower than those in patients on hemodialysis (HD), more recent studies demonstrated lower s-β2m concentrations in HD patients treated mainly with high-flux synthetic membranes. We therefore compared s-β2m concentrations between patients on PD and on HD, and also analyzed the relationship between s-β2m concentrations and other parameters in patients on PD. Patients and Methods We investigated 24 patients who had been undergoing PD [11 on continuous ambulatory peritoneal dialysis, 13 on continuous cycling peritoneal dialysis] for 4.3 ± 2.7 years, and 24 patients who had been undergoing HD with high-flux synthetic membranes for 6.1 ± 3.2 years. Concentrations of s-β2m in the PD patients were compared to concentrations in the HD patients. In patients on PD, we also analyzed the relationship between s-β2m concentration and other parameters, including residual renal function, total weekly Kt/V urea, total weekly creatinine clearance (CCr), and dialysis schedules. Results We found no significant difference in s-β2m concentrations between the PD and HD patients (33.6 ± 10.4 mg/L vs 30.3 ± 10.5 mg/L respectively). Concentrations of s-β2m in PD patients rose with PD duration and were significantly inversely correlated with residual renal function ( r = –0.71, p < 0.0001). Unexpectedly, concentrations of s-β2m in anuric PD patients rose as peritoneal CCr increased. And most of the patients with high s-β2m levels fell into the high or high-average transport categories according to a peritoneal equilibration test. Conclusions Concentrations of s-β2m in patients on PD did not differ significantly from concentrations in HD patients who were using high-flux synthetic membranes. The contribution of residual renal function to removal of β2m was more important than the contribution of peritoneal clearance. High peritoneal clearance of small molecules did not result in low s-β2m concentrations, especially in anuric patients with accelerated peritoneal permeability.

Baseline and Time-Averaged Values Predicting Residual Renal Function Decline Rate in Japanese Peritoneal Dialysis Patients

2017 ◽  
Vol 21 (6) ◽  
pp. 599-605 ◽  
Author(s):  
Kiyotaka Uchiyama ◽  
Akane Yanai ◽  
Keizo Maeda ◽  
Keisuke Ono ◽  
Kazuya Honda ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Residual Renal Function ◽  
Dialysis Patients ◽  
Renal Function Decline ◽  
Decline Rate
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