Loss of Residual Renal Function was Not Associated with Glycemic Control in Patients on Peritoneal Dialysis

2011 ◽  
Vol 31 (2) ◽  
pp. 154-159 ◽  
Author(s):  
Su-Ah Sung ◽  
Young-Hwan Hwang ◽  
Sejoong Kim ◽  
Sung Gyun Kim ◽  
Jieun Oh ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Glycemic Control ◽  
Hemoglobin A1c ◽  
Diastolic Pressure ◽  
Residual Renal Function ◽  
First Year ◽  
Diabetic Patients ◽  
Measured Glomerular Filtration Rate ◽  
The Relationship

BackgroundBetter glycemic control has been reported to slow the progression of nephropathy in predialysis diabetic patients. However, the relationship between glycemic control and residual renal function (RRF) in patients on peritoneal dialysis (PD) is uncertain.Methods89 incident diabetic patients on PD were recruited from 5 centers. We measured glomerular filtration rate (GFR) and hemoglobin A1c (HbA1c) within 2 months (baseline) after the start of PD and at 6 and 12 months. GFR was calculated as the average of renal creatinine and urea clearances. We analyzed whether mean HbA1c was associated with change in GFR (ΔGFR) over 1 year.ResultsDuring the first year of PD, ΔGFR was -1.7 ± 3.4 mL/min/1.73 m2and was not affected by mean HbA1c. Acute hemodialysis before starting PD and mean arterial diastolic pressure were related to the decline of GFR in a multivariate analysis.ConclusionGlycemic control was not associated with change in RRF in diabetic patients during the first year after starting PD.

Treatment Targets for Diabetic Patients on Peritoneal Dialysis: Any Evidence?

2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 176-179 ◽  
Author(s):  
Chiu-Ching Huang
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Glycemic Control ◽  
Clinical Outcome ◽  
Small Molecules ◽  
Residual Renal Function ◽  
Diabetic Patients ◽  
Peritoneal Membrane ◽  
Comorbid Conditions ◽  
Dialysis Solutions

Diabetic patients are often affected by comorbid conditions that influence clinical outcome. Taking care of diabetic peritoneal dialysis (PD) patients is a challenge for nephrologists, not only because these patients have more complications and comorbidities, but also because of their difficulties in maintaining glycemic control with the use of current glucose-containing dialysis solutions. In addition, the increased transport of small molecules and proteins by the peritoneal membrane in diabetic patients adds the further problems of ultrafiltration deficit and malnutrition. The present article reviews pertinent evidence toward establishing the best strategy for the care of diabetic PD patients. With better glycemic control, improved nutrition, improved fluid balance, and optimal preservation of residual renal function, there is hope for improving the survival of diabetic PD patients.

scholarly journals SP483EXCESS WEIGHT GAIN DURING THE FIRST YEAR OF PERITONEAL DIALYSIS IS A RISK FACTOR FOR A RAPID DECREASE IN RESIDUAL RENAL FUNCTION

2015 ◽  
Vol 30 (suppl_3) ◽  
pp. iii539-iii539
Author(s):  
Hyung Jik Kim ◽  
Sung Gyun Kim ◽  
Jwa-Kyung Kim ◽  
Chan Ho Kim ◽  
Seung Jun Kim ◽  
...  
Keyword(s):  
Renal Function ◽  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Weight Gain ◽  
Residual Renal Function ◽  
Rapid Decrease ◽  
First Year

scholarly journals P1207ANALYSIS OF OUTCOME AND FACTORS ASSOCIATED WITH MAINTENANCE OF PERITONEAL DIALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Merita Rroji (Molla) ◽  
Saimir Seferi ◽  
Larisa Shehaj ◽  
Myftar Barbullushi
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Residual Renal Function ◽  
Good Survival ◽  
First Year ◽  
Technical Failure ◽  
Technique Survival ◽  
Ultrafiltration Failure ◽  
Comorbidity Index ◽  
Short Time

Abstract Background and Aims Peritoneal dialysis (PD) is generally associated with a good survival rate and with great preservation of residual renal function (RRF). The various causes of technique failure are responsible for the relative short time staying in PD. Objectives: This study aimed to analyze the outcome and factors correlated with maintenance peritoneal dialysis (PD) to guide for improving prognosis. Method In a retrospective way we examined our PD-cohort concerning mortality, technique survival, peritonitis rate, and other complications. Results From 2005 to 2019 the number of PD patients who have been treated in PD program for more than 3 months was around 199 patient, 29.1% diabetics, mean age 53.3±15.03 years old and meantime in therapy 32.39± 27.34 months. The PD was seen as an alternative for younger patients in the transplant list and elderly patients with comorbidity. Around 7.5% of the PD patients were transplanted and 8.5 % of patients were transferred from HD due to vascular access failure. Around 88.9% of patients were on PD for more than 1 year, 37.7% from 3 up to 5 years and 19.8% percent of the patients have stayed on PD for more than 5 years. Cardiovascular mortality was the main cause of mortality with 53% of the cases. Higher comorbidity index, lower albumin levels, and lower residual renal function were the main risk factors for lower survival. The technical survival of patients was 92.3% during the first year, 79.5% and 69.6% in the second and the fifth year, respectively. There was not found a difference in technical survival between diabetics and nondiabetics patients. Ultrafiltration failure followed by peritonitis was the main reason for transfer patients with more than 24 months in therapy in hemodialysis probably linked with the no availability of icodextrin. Peritonitis rate was 1:41 patient months. Conclusion PD program in our center is organized based in the concept of integrated care in RRT. The outcome of our patients was at least comparable to those reported by larger registries Although we have done good progress in the prevention of infection the nonavailability of icodextrin is an important factor for a technical failure. RRF is an important factor and we need to be more focused to maintain it longer in the future.

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 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.

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