Waist Circumference as a Predictor of Adiponectin Levels in Peritoneal Dialysis Patients: A 12-Month Follow-up Study

ObjectivesThis prospective study, conducted at the dialysis unit of the Nephrology Division, Federal University of Sao Paulo–Oswaldo Ramos Foundation, Brazil, aimed to evaluate whether waist circumference (WC) can predict adiponectin levels in patients undergoing peritoneal dialysis (PD).MethodsAmong 115 patients on PD at a single dialysis center who were evaluated at 6 and 12 months, 57% were men, 31% had diabetes, mean age was 52.8 ± 16.1 years, body mass index was 25 ± 4.3 kg/m2, and dialysis vintage was 13 months (range: 5 – 33 months). We measured WC at the umbilicus level. Adiponectin was determined by an enzyme-linked immunosorbent assay.ResultsAt baseline, WC was inversely associated with adiponectin ( r = –0.48, p < 0.01). After adjustment for sex, age, diabetes, peritoneal clearance, and residual renal function, WC was an independent determinant of serum adiponectin (β = –0.52; 95% confidence interval: –0.73 to –0.31; p < 0.001). In the prospective analysis, after adjustment for confounders, changes in WC predicted changes in adiponectin. For each unit increase in WC, adiponectin declined by 0.39 mg/L ( p < 0.001).ConclusionsThis study demonstrates that WC is associated with adiponectin and, more importantly, that this simple marker of central adiposity was able to predict changes in adiponectin levels over time.

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Residual renal function and blood count in patients on continuous ambulatory peritoneal dialysis

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0612503j ◽

2006 ◽

Vol 134 (11-12) ◽

pp. 503-508

Author(s):

Natasa Jovanovic ◽

Mirjana Lausevic ◽

Biljana Stojimirovic

Keyword(s):

Renal Failure ◽

Renal Function ◽

Peritoneal Dialysis ◽

Chronic Renal Failure ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Blood Count ◽

Residual Renal Function ◽

Co Morbidity ◽

Positive Correlations

Introduction:Most of patients with chronic renal failure are affected by normochromic, normocytic anemia caused by different etiological factors. Anemia causes a series of symptoms in chronic renal failure, which can hardly be recognized from the uremic signs. Anemia adds to morbidity and mortality rates in patients affected by advanced chronic renal failure. Blood count partially improves during the first months after starting the chronic renal replacement therapy, in correlation with the quality of depuration program, with extension of erythrocyte lifetime and with hemoconcentration due to reduction of plasma volume. Recent trials found that higher residual renal function (RRF) significantly reduced co-morbidity, the rate and duration of hospitalization and risk of treatment failure. Objective: The aim of the study was to follow blood count parameters in 32 patients on chronic continuous ambulatory peritoneal dialysis (CAPD) during the first six months of treatment, to evaluate the influence of demographic and clinical factors on blood count and RRF, and to examine the correlation between RRF and blood count parameters. Method: A total of 32 patients affected by end-stage renal disease of different major cause during the first six months of CADP treatment were studied. RRF and blood count were evaluated as well as their relationship during the follow-up. Results: Blood count significantly improved in our patients during the first six months of CAPD treatment even if Hb and HTC failed to reach normal values. Iron serum level slightly decreased because of more abundant erythropoiesis and iron utilization during the first six months of treatment. RRF slightly decreased. After six months of CAPD treatment, the patients with higher RRF had significantly higher Hb, HTC and erythrocyte number and a lot of positive correlations between RRF and anemia markers were observed. Conclusion: After 6-month follow-up period, the patients with higher RRF had significantly higher blood count parameters, and several positive correlations between RRF and blood count markers were confirmed.

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Abstract 24: Changes in Generalized and Central Adiposity are Dynamically Associated with Left Ventricular Remodeling

Circulation ◽

10.1161/circ.133.suppl_1.24 ◽

2016 ◽

Vol 133 (suppl_1) ◽

Author(s):

Bryan R Wilner ◽

Sonia Garg ◽

Colby R Ayers ◽

Satyam Sarma ◽

Anand Rohatgi ◽

...

Keyword(s):

Weight Loss ◽

Weight Gain ◽

Waist Circumference ◽

Ventricular Remodeling ◽

Left Ventricular Remodeling ◽

Left Ventricular ◽

Study Cohort ◽

Central Adiposity ◽

Lv Mass

Introduction: Obesity is linked to an adverse cardiac structural phenotype in cross-sectional studies. However, the effects of longitudinal changes in generalized and central adiposity on left ventricular (LV) remodeling are unknown. Methods: Participants without baseline cardiovascular disease or LV dysfunction in the Dallas Heart Study underwent assessment of body composition and cardiac structure by MRI at baseline and then 7 years later. Associations between change in weight and waist circumference with alterations in structure and function were assessed using multivariable linear regression. Results: The study cohort (n=1262) had a mean age of 44 years and was 43% (545 of 1262) male, 44% (556 of 1262) African-American, and 36% (460 of 1262) obese at baseline. At 7 years follow-up, 7% (85 of 1262) had >10% weight loss, 8% (108 of 1262) had 5-10% weight loss, 44% (551 of 1262) had <5% weight change, 20% (248 of 1262) had 5-10% weight gain, and 21% (270 of 1262) had >10% weight gain. Those who gained >10% weight were younger, had lower BMI and LV mass at baseline, and had greater increases in blood pressure, glucose, triglycerides, LDL cholesterol, and hs-CRP over follow-up. In multivariable models adjusted for age, sex, race, and baseline and interim development of comorbidities, 1-standard deviation increases in body weight and waist circumference over follow-up were significantly associated with higher LV mass, LV wall thickness, and concentricity; but minimally or not significantly associated with LV end-diastolic volume or ejection fraction (EF) (Table). Conclusion: Increases in generalized and central adiposity are characterized primarily by concentric remodeling, with a more modest impact on LV volume and EF. These results support the notion that the development of specific obesity patterns may impact cardiac remodeling with potential implications for the development of cardiac hypertrophy and heart failure.

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Fasting Serum Ghrelin Level is Associated with Metabolic Syndrome in Peritoneal Dialysis Patients

Peritoneal Dialysis International ◽

10.1177/089686080802803s36 ◽

2008 ◽

Vol 28 (3_suppl) ◽

pp. 196-200

Author(s):

Chung-Jen Lee ◽

Yi-Maun Subeq ◽

Chih-Hsien Wang ◽

Ru-Ping Lee ◽

Te-Chao Fang ◽

...

Keyword(s):

Metabolic Syndrome ◽

Regression Analysis ◽

Peritoneal Dialysis ◽

Waist Circumference ◽

Linear Regression ◽

Diagnostic Criteria ◽

Linear Regression Analysis ◽

Enzyme Linked Immunosorbent Assay ◽

Fasting Serum ◽

Serum Ghrelin

⋄ Background Serum ghrelin levels are elevated in uremic patients. However, no data are available on the relationship between metabolic syndrome and serum ghrelin levels in peritoneal dialysis (PD) patients. ⋄ Methods Metabolic syndrome and its components were defined using diagnostic criteria recommended by the International Diabetes Federation. Fasting serum samples were taken from 30 PD patients. Serum ghrelin levels were measured by using a commercial enzyme-linked immunosorbent assay kit. ⋄ Results Of the 30 PD patients, 53.3% (16/30) had metabolic syndrome. Fasting serum ghrelin corrected inversely with metabolic syndrome among these PDs patients ( p = 0.002). By odds ratio (OR) analysis of metabolic syndrome and metabolic syndrome diagnostic criteria, the predictors for metabolic syndrome are fasting glucose [OR: 39.00; 95% confidence interval (CI): 3.80 to 399.85; p < 0.001], triglycerides (OR: 37.50; 95% CI: 3.64 to 386.51; p < 0.001), and waist circumference (OR: 4.20; 95% CI: 1.95 to 9.03; p < 0.001). Univariate linear regression analysis showed that body weight ( r = –0.461, p = 0.010), waist circumference ( r = –0.390, p = 0.033), and body mass index ( r = –0.438, p = 0.016) were negatively correlated with serum ghrelin, and serum high density lipoprotein [HDL ( r = 0.626, p < 0.001)] was positively correlated with serum ghrelin. Multivariate forward stepwise linear regression analysis of the significant variables showed that HDL ( R2 change = 0.392; p < 0.001) was the independent predictor of serum ghrelin in PD patients and explained 39.2% of the variance. ⋄ Conclusions These results indicate an inverse association between circulating fasting ghrelin and metabolic syndrome in PD patients. Serum HDL was associated with serum ghrelin among PD patients.

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P1145ADEQUACY AND SURVIVAL IN PERITONEAL DIALYSIS: TEN YEARS EXPERIENCE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1145 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Vincenzo Terlizzi ◽

Elena Pezzini ◽

Roberta Cortinovis ◽

Diana Bertoni ◽

Alessandra Pola ◽

...

Keyword(s):

Diabetes Mellitus ◽

Peritoneal Dialysis ◽

Protective Factor ◽

Residual Renal Function ◽

Dialysis Modality ◽

Dialysis Adequacy ◽

Dialysis Treatment ◽

Increased Risk ◽

Uremic Patients

Figure: Background and Aims in Italy only a minority of uremic patients perform peritoneal dialysis (PD). In dialysis centers where PD is practiced and proposed the prevalence is no more than 23%. Proposed advantages of PD over HD are a more preserved Residual renal function (RRF), that has been associated with better survival, and better Quality of life (Qol) due to possible more preservation of previous lifestyle, independence, possibility of traveling, and flexibility. Incremental peritoneal dialysis is a promising way to further improve Qol and to preserve RRF. Lastly, PD is less expensive than HD. Aim of this study has been to retrospectively evaluate our ten-years experience of PD treatment on survival, dialysis adequacy, preservation of RRF and nutrition in uremic patients followed at our Dialysis Center. Method We retrospectively evaluated all the incident patients that started PD treatment due to uremia from 01-01-2008 to 31-12-2018 at the U.O. Nephrology ASST Spedali Civili of Brescia. The exclusion criteria were time of dialysis treatment less than 3 months and absence of previous dialytic treatment or kidney transplantation. For each patient anthropometric, clinical-anamnestic data and comorbidities at dialysis start were recorded. Data on dialysis adequacy, nutrition, RRF and PD dialysis modality performed were also recorded. Results During the observation period 329 patients started PD. 60 were excluded due to follow-up of less than 3 months. Therefore, 269 patients (males 160, 59%) were studied. The average age was 65±16 years, BMI 24±4 kg/m2. Comorbidities were: hypertension (87%), diabetes mellitus (32%), cerebral vascular disease (26%) and ischemic heart disease (25%). The mean duration of dialysis treatment was 2.1±1.5 years. At the end of ten-years follow-up 24% of patients have had a kidney transplant, 18% were on PD treatment, 17% have had a shift towards HD, 39% had died. The main causes of death were: infection (39%) and cardiovascular disease (31%). The most common dialysis modality performed was APD (61%); CAPD was performed in 39% of pts. Dialysis modality (CAPD; APD), nutrition parameters (PNA; BMI), as well as RRF, expressed as an average value during follow-up, are shown in Figure 1. 81 patients (30%) were treated with incremental PD; 85% of them with manual exchanges. The comparison of dialysis parameters between incremental PD and standard PD are shown in Figure 2. Multivariate analysis with survival as dependent variable (Figure 3), showed that age, diabetes mellitus, and low wKt/V were independently associated with an increased risk of mortality. Diuresis volume and male gender were protective factors. No independent influence on mortality of the dialysis treatment modality was found. Conclusion In this ten-years experience of patients undergoing PD at our Center, incremental PD seems to be a protective factor for the maintenance of a preserved diuresis and better dialysis adequacy, and these factors are associated with better survival of the patients.

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

Peritoneal Dialysis International ◽

10.3747/pdi.2016.00206 ◽

2017 ◽

Vol 37 (3) ◽

pp. 283-289 ◽

Cited By ~ 11

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.

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Ciprofloxacin and Cefazolin as a Combination for Empirical Initial Therapy of Peritoneal Dialysis-Related Peritonitis: Five-year Follow-up

Peritoneal Dialysis International ◽

10.1177/089686080702700113 ◽

2007 ◽

Vol 27 (1) ◽

pp. 56-60 ◽

Cited By ~ 12

Author(s):

Renata C.S. Lima ◽

André Barreira ◽

Fernando L. Cardoso ◽

Marcio H.S. Lima ◽

Maurilo Leite

Keyword(s):

Peritoneal Dialysis ◽

Low Cost ◽

Cost Effective ◽

Initial Therapy ◽

Careful Examination ◽

Dialysis Unit ◽

Therapeutic Trials ◽

First Choice ◽

Oral Ciprofloxacin

The treatment of peritoneal dialysis (PD)-related peritonitis has been a matter of extensive investigation, frequently generating therapeutic trials. Several combinations of antibiotics have served as newer protocols and tended to be efficacious, comfortable, and cost-effective. According to the more recent recommendations from the International Society for Peritoneal Dialysis, the rationale for empirical initial therapy of clinically detected peritonitis in PD patients has been to follow the bacterial profile derived from cultured specimens of PD effluents. The current study describes 5 year's experience with the use of a new antibiotic regimen for the treatment of peritonitis. We herein analyze the outcome of 95 episodes of peritonitis in 54 patients on either automated PD or continuous ambulatory PD at the dialysis unit of the Federal University of Rio de Janeiro. Peritoneal dialysis-related peritonitis was treated with the combination of oral ciprofloxacin and intraperitoneal cefazolin. The observed cure rate was 85.2% and the sensitivity test was observed to be positive for this combination of antibiotics in 88.9% of positive cultures. Of the 14 unsuccessful episodes, 7 were due to catheter colonization and the rest did not respond to the proposed therapy within 48 hours. These 7 cases were also related to peritoneal fluid cultures that were resistant to both ciprofloxacin and cefazolin. From this study, we propose this combination of oral ciprofloxacin and intraperitoneal cefazolin as a first choice for empirical initial therapy of PD-related peritonitis, given its efficacy and low cost. However, in order to apply the most adequate cost-effective therapy, careful examination of the bacterial profile and sensitivities to antibiotics used in each unit is strongly recommended.

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Characteristics and Outcomes of Fungal Peritonitis in a Modern North American Cohort

Peritoneal Dialysis International ◽

10.3747/pdi.2013.00179 ◽

2015 ◽

Vol 35 (1) ◽

pp. 78-84 ◽

Cited By ~ 12

Author(s):

Annie-Claire Nadeau-Fredette ◽

Joanne M Bargman

Keyword(s):

Peritoneal Dialysis ◽

North American ◽

Significant Proportion ◽

Dialysis Patients ◽

Fungal Peritonitis ◽

Risk Of Death ◽

Dialysis Vintage ◽

Unit Increase ◽

Wbc Count ◽

Technique Failure

IntroductionPeritonitis remains a common complication of peritoneal dialysis (PD). Although representing only 1 – 12% of overall peritonitis in dialysis patients, fungal peritonitis (FP) is associated with serious complications, including technique failure and death. Only scarce data have been published regarding FP outcomes in modern cohorts in North America. In this study we evaluated the rates, characteristics and outcomes of FP in a major North American PD center.MethodsWe conducted a retrospective cohort study including all fungal peritonitis episodes among peritoneal dialysis patients followed in a large PD center between January 2000 and February 2013. Our pre-specified end-points included rates of FP, characteristics, outcomes and determinants of death.ResultsThirty-six episodes of FP were identified during the follow-up period (one episode per 671 patient-months), representing 4.5% of the total peritonitis events. Patients’ mean age and peritoneal dialysis vintage were 61.3 ± 15.5 and 2.9 (1.5 – 4.8) years, respectively. Of the 36 episodes of FP, seven (19%) resulted in death and 17 (47%) led to technique failure with permanent transfer to hemodialysis. Surprisingly, PD was eventually resumed in 33% of cases with a median delay of 15 weeks (interquartile range 8 – 23) between FP and catheter reinsertion. In a univariable analysis, a higher Charlson comorbidity index (Odds ratio [OR] 3.25 per unit increase, 95% confidence interval [CI] 1.23 – 8.58) and PD fluid white blood cell (WBC) count greater than 3,000/mm3at presentation (OR 6.56, 95% CI 1.05 – 40.95) predicted death.ConclusionWhile fungal peritonitis is still associated with a high frequency of death and technique failure, one-third of our patients eventually returned to PD. Patients with a high burden of comorbidities appear at higher risk of death. We postulate that the high mortality associated with FP is partially related to the severity of comorbidity among patients with F P, rather than the infection per se. Importantly, PD can be resumed in a significant proportion of cases.

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Survival Comparison between Hemodialysis and Peritoneal Dialysis Based on Matched Doses of Delivered Therapy

Journal of the American Society of Nephrology ◽

10.1681/asn.v13suppl_1s48 ◽

2002 ◽

Vol 13 (suppl 1) ◽

pp. S48-S52

Author(s):

Prakash Keshaviah ◽

Allan J. Collins ◽

Jennie Z. Ma ◽

David N. Churchill ◽

Kevin E. Thorpe

Keyword(s):

Renal Function ◽

Peritoneal Dialysis ◽

Lower Risk ◽

Residual Renal Function ◽

Dialysis Session ◽

Comorbid Conditions ◽

Urea Nitrogen ◽

Risk Of Death ◽

Patients With Diabetes

ABSTRACT. Several studies have recently confirmed that hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) survival is highly associated with delivered therapy Kt/Vurea. A direct comparison of equivalently dosed CAPD and HD has not previously been performed. A total of 968 incident HD patients at the Regional Kidney Disease Program from 1987 to June 1995 were studied, and these results were compared with those of the Canadian-United States prospective trial (CANUSA) consisting of 680 incident CAPD patients from September 1990 to December 31, 1992, with follow-up through December 31, 1993. All patients had quantitation of urea nitrogen for a total delivered dialysis session. On HD, in vivo, 2-pool, pre- and post-blood urea nitrogen kinetic modeling was performed with residual renal function determined every 6 mo. Patients were characterized by age, gender, race, renal diagnosis, and comorbid conditions. A Cox proportional hazards model was used to evaluate the effect of the individual comorbid conditions and the effect of dialysis therapy in the time-dependent method. The mean total Kt/V, both residual renal function and dialytic therapy in the HD patients, was 1.59. The CANUSA-delivered weekly Kt/V was 2.38 at the beginning of the baseline period and 1.99 after 24 mo of follow-up. When the peak concentration hypothesis was used, a Kt/V of 1.59 on HD was equivalent to a weekly CAPD dose of 2.1 to 2.2. A 1-unit increase in Kt/V was associated with 7% lower risk of death on HD and with a similar 8% lower risk of death while on CAPD. Patients with diabetes aged 46 to 60 yr had virtually identical 2-yr survival estimates on HD (83 to 90%), compared with CAPD (83 to 89%), with Kt/V ranges from 0.84 to 1.70 in HD and from 1.6 to 2.2 weekly Kt/V on peritoneal dialysis. Comparisons between HD and CAPD in older patients with diabetes yielded comparable results. Patient survival is highly influenced by delivered dialysis in both HD and peritoneal dialysis. Carefully matching of the therapies with delivered Kt/V demonstrates little differences in the survival outcome of HD and peritoneal dialysis patients, in contrast to some previous reports.

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P1135WHETHER USPD PATIENTS ARE SUITABLE FOR INCREMENTAL PERITONEAL DIALYSIS:YES OR NO?

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1135 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Wenjing Zhang ◽

Jia LV ◽

Lan Li ◽

Zhigang Wang ◽

Dapeng Hao ◽

...

Keyword(s):

Renal Function ◽

Peritoneal Dialysis ◽

Urine Volume ◽

Residual Renal Function ◽

Dialysis Dose ◽

Dialysis Adequacy ◽

Exit Site Infection ◽

Full Dose ◽

Mechanical Complications

Abstract Background and Aims Incremental Peritoneal Dialysis (IPD) is the practice of initiating PD exchange less than four times a day in consideration of residual renal function (RRF). More clinical studies have confirmed the feasibility and effectiveness of IPD, especially in the protection of residual renal function, which is obviously superior to full-dose PD. Urgent-start peritoneal dialysis (USPD) is a popular PD method. Due to lack of pre-dialysis education, most of patients who were newly diagnosed with ESRD in China chose USPD. Well, can incremental peritoneal dialysis be used for USPD patients when starting dialysis? Compared to full-dose PD, whether incremental PD affects the residual renal function in USPD patients? Here we report the first study of incremental peritoneal dialysis’s effect on residual renal function. Method A retrospective analysis of medical records was performed on 169 patients who received USPD from August 2008 to March 2017. Patients were divided into 2 groups according to dialysis dose: incremental PD(i-PD) group (dialysis dose were less than or equal to 6000ml or 3 exchanges per day) and full-dose PD(f-PD) group (dialysis dose were great than or equal to 8000ml or 4 exchanges per day). The demographics, clinical biochemical indexes, dialysis dose, urine volume, dialysis ultrafiltration volume, RRF, dialysis adequacy, peritoneal dialysis infection complications, mechanical complications and survival rates were compared between two groups in 1 year follow-up. Results: (1).A total of 169 patients were enrolled, including 111 patients (average age 45.01±12.84 years) in i-PD group and 58 patients (average age 43.5±15.62 years) in f-PD group. The demographics and clinical biochemical indexes in the two groups before peritoneal dialysis were similar (P>0.05). (2).During the follow-up period, the dialysis dose in f-PD group(8034.48±262.61ml/d, 8080.00±395.80ml/d, 8155.17±523.21ml/d, 8051.72±906.55ml/d) were more than those in i-PD group(5891.89±528.31ml/d, 6159.57±1185.06ml/d, 6468.47±1588.71ml/d, 6900.90±1543.05ml/d), P<0.05. And the dialysis adequacy in both groups were up to standard: the total Kt/V (i-PD group: 1.96±0.56, 2.01±0.70, 2.02±0.55, 1.90±0.52; f-PD group: 2.18±0.47, 2.22±0.55, 2.05±0.44, 2.03±0.42) were greater than 1.7 and the total Ccr (i-PD group: 79.39±29.75, 79.02±25.11, 78.26±30.00, 73.09±29.14; f-PD group: 89.78±29.89, 91.54±35.56, 82.38±29.27, 72.96±23.75) were greater than 60L. (3).During the whole follow-up period, the residual renal function between two groups had no statistically significant(i-PD group: 3.96±2.52ml/min, 3.46±1.95ml/min, 3.58±2.85ml/min, 2.91±2.33ml/min; f-PD group: 4.31±4.83ml/min, 3.45±2.36ml/min, 3.16±2.15ml/min, 2.36±1.65ml/min), P>0.05. (4).During the whole follow-up period, the blood pressure control, correction of anemia, and correction of calcium and phosphorus abnormalities were also similar in both groups, P>0.05. (5).At 1-month and 6-month, the urine volume were higher in i-PD group(1024.33±492.91ml/d, 1017.03±571.66ml/d) than those in f-PD group(782.93±415.89ml/d, 788.27±491.02ml/d), P<0.05. The dialysis ultrafiltration volume in f-PD group (481.67±723.69ml/d, 632.77±687.89ml/d, 338.87±963.14ml/d, 750.43±849.69ml/d) were higher than those in i-PD group(343.30±520.00ml/d, 495.70±916.76ml/d, 341.78±925.57ml/d, 439.65±1297.13ml/d) during the whole follow-up period, but the differences were not statistically significant (P>0.05). (6).The exit-site infection, peritonitis, mechanical complications and technical survival were similar between the two groups (P>0.05). Conclusion Incremental peritoneal dialysis will not cause rapid decline of residual renal function in USPD patients, and the dialysis effect and complications are similar to full-dose peritoneal dialysis. Therefore, we recommend that USPD patients can be treated by incremental peritoneal dialysis.

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Changes in Peritoneal Transport during the First Month of Peritoneal Dialysis

Peritoneal Dialysis International ◽

10.1177/089686089501500103 ◽

1995 ◽

Vol 15 (1) ◽

pp. 12-17 ◽

Cited By ~ 30

Author(s):

Michael V. Rocco ◽

Jean R. Jordan ◽

John M. Burkart

Keyword(s):

Peritoneal Dialysis ◽

Medical Center ◽

Group Versus ◽

Dialysis Patients ◽

Dialysis Unit ◽

Peritoneal Transport ◽

Time Period ◽

Initiation Of Dialysis ◽

Calculated Mass

Objective To determine if peritoneal transport characteristics change during the initial month of peritoneal dialysis. Design Retrospective review of peritoneal equilibration test (PET) results in patients who received their first PET during the first two weeks of peritoneal dialysis (early PET group) versus patients who received their first PET between four and 28 weeks after the initiation of dialysis (late PET group). The initial PET values were compared to subsequent PET results obtained approximately seven months after the initial PET. Setting Peritoneal dialysis unit of a tertiary medical center. Outcome Measures PET results and calculated mass transfer area coefficient (MT AC) values. Patients Thirty-four peritoneal dialysis patients in the early PET group and 17 peritoneal dialysis patients in the late PET group. Results In the early PET group, there was a statistically significant increase from the initial to follow-up values for both dialysate-to-plasma (DIP) creatinine and MTAC creatinine (p < 0.01) as well as a significant decrease for four-hour dialysate to initial dialysate ratios (DID) glucose (p = 0.08) and MTAC glucose (p < 0.05). In the late PET group, there was no significant change in any of these parameters with time. However, in the late PET group, there was a significant decrease in DIP urea values with time (p < 0.01), but not with MTAC urea. In addition, there were no differences over time in either group for serum albumin or hematocrit values. Conclusion During the first two weeks of peritoneal dialysis, there tends to be a change in peritoneal transport characteristics in some patients. PET data obtained during this time period should be interpreted as preliminary.

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