Anemia is Correlated with Malnutrition and Inflammation in Croatian Peritoneal Dialysis Patients: A Multicenter Nationwide Study

2017 ◽  
Vol 37 (4) ◽  
pp. 472-475 ◽  
Author(s):  
Josipa Radić ◽  
Nikolina Bašic-Jukić ◽  
Božidar Vujicić ◽  
Dragan Klarić ◽  
Goran Radulović ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Clinical Laboratory ◽  
Binding Capacity ◽  
Albumin Level ◽  
Weekly Dose ◽  
Anthropometric Parameters ◽  
Reactive Protein ◽  
Anemia Management

Malnutrition, inflammation, and anemia are common in peritoneal dialysis (PD) patients. In this study, correlations between Malnutrition Inflammation Score (MIS), laboratory and anthropometric parameters, and anemia indices in Croatian PD patients were analyzed. One hundred and one PD patients (males/females 54/47, age 58.71 ± 14.68 years, mean PD duration 21.82 ± 21.71 months) were included. Clinical, laboratory, and anthropometric parameters were measured. Statistically significant correlations between MIS and erythropoietin weekly dose per kg of body weight (ESA weekly dose), hemoglobin (Hb), and erythrocytes were found ( r = 0.439, p < 0.001; r = -0.032, p < 0.001; r = -0.435, p < 0.001), respectively. Also, statistically significant correlations were found between MIS and mean corpuscular volume ( r = 0.344, p < 0.001), iron ( r = -0.229, p = 0.021), and total iron binding capacity (TIBC) ( r = -0.362, p < 0.001), respectively. Furthermore, statistically significant correlations between ESA weekly dose and serum albumin level and body mass index (BMI) were found ( r = -0.272, p = 0.006; r = -0.269, p = 0.006), respectively. When we divided PD patients into 2 groups according Hb level (Hb ≥ 11 0 [ N = 60, 59.41 %]) and Hb < 110 [ N = 41, 40.59%]), statistically significant differences were found in MIS score (3.02 ± 2.54 vs 4.54 ± 3.54, p = 0.014), C-reactive protein (CRP) (3.52 ± 6.36 vs 7.85 ± 7.96, p = 0.005), and serum albumin level (44.22 ± 8.54 vs 39.94 ± 8.56, p = 0.003), respectively. Our findings suggest that anemia is correlated with malnutrition and inflammation in Croatian PD patients. Further studies are needed to assess whether modulating inflammatory or nutritional processes can improve anemia management in PD patients.

scholarly journals Hypoalbuminemia, cardiac morbidity, and mortality in end-stage renal disease.

1996 ◽  
Vol 7 (5) ◽  
pp. 728-736 ◽  
Author(s):  
R N Foley ◽  
P S Parfrey ◽  
J D Harnett ◽  
G M Kent ◽  
D C Murray ◽  
...  
Keyword(s):  
Heart Disease ◽  
Peritoneal Dialysis ◽  
Ischemic Heart Disease ◽  
Serum Albumin ◽  
Cardiac Failure ◽  
Serum Albumin Level ◽  
De Novo ◽  
Albumin Level ◽  
Dialysis Patients ◽  
Overall Mortality

A cohort of 432 ESRD (261 hemodialysis and 171 peritoneal dialysis) patients was followed up prospectively for an average of 41 months. Baseline and annual demographic, clinical, and echocardiographic assessments were performed, as well as serial clinical and laboratory tests measured monthly while patients were on dialysis therapy. Among hemodialysis patients, after adjustment was made for age, diabetes, and ischemic heart disease, as well as hemoglobin and blood pressure levels measured serially, a 10-g/L fall in mean serum albumin level was independently associated with the the development of de novo (relative risk [RR], 2.22; P = 0.001) and recurrent cardiac failure (RR, 3.84; P = 0.003), de novo (RR, 5.29; P = 0.001) and recurrent ischemic heart disease (RR, 4.24; P = 0.005), cardiac mortality (RR, 5.60; P = 0.001), and overall mortality (RR, 4.33; P < 0.001). Among peritoneal dialysis patients, a 10-g/L fall in mean serum albumin level was independently associated with the progression of left ventricular dilation as seen on follow-up echocardiography (beta, 13.4 mL/m2; P = 0.014), the development of de novo cardiac failure (RR, 4.16; P = 0.003), and overall mortality (RR, 2.06; P < 0.001). Hypoalbuminemia, a major adverse prognostic factor in dialysis patients, is strongly associated with cardiac disease.

scholarly journals Favored serum albumin level and ICF volume after use of 1.1% aminoacid based peritoneal dialysis(PD) solution

2012 ◽  
Vol 31 (2) ◽  
pp. A87
Author(s):  
Jong-woo Yoon ◽  
Myung-jin Choi ◽  
Ja-ryong Koo ◽  
Young-ki Lee ◽  
Jung-woo Noh
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Albumin Level

Duration of dialysis and its relationship to dialysis adequacy, anemia management, and serum albumin level

2001 ◽  
Vol 38 (4) ◽  
pp. 813-823 ◽  
Author(s):  
Michael V. Rocco ◽  
Marjorie R. Bedinger ◽  
Roger Milam ◽  
Joel W. Greer ◽  
William M. McClellan ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Dialysis Adequacy ◽  
Anemia Management

Incidence and risk factors of peritoneal dialysis-related peritonitis in elderly patients: A retrospective clinical study

2020 ◽  
Vol 40 (1) ◽  
pp. 26-33 ◽  
Author(s):  
Haishan Wu ◽  
Hongjian Ye ◽  
Rong Huang ◽  
Chunyan Yi ◽  
Juan Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Elderly Patients ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Advanced Age ◽  
Retrospective Clinical Study ◽  
Technique Failure ◽  
Related Mortality

Background: This study was to analyze the incidence, risk factors, and clinical outcomes of peritonitis in elderly continuous ambulatory peritoneal dialysis (CAPD) patients. Methods: Incident patients undergone CAPD from 1 January 2006 to 30 June 2015 in our center were enrolled and divided into aged < 65 years and ≥ 65 years groups. Risk factors were evaluated using a logistic regression model, and outcome comparison was evaluated using a Cox proportional model. Results: Among 1953 patients, 111(33.2%) in elderly ( n = 334) and 470 (29.0%) in younger ( n = 1619) developed at least one episode of peritonitis. Comparing with younger patients, elderly ones had a higher peritonitis rate (0.203 vs. 0.145 episodes/patient-year, p < 0.05). The multivariate Cox regression showed that advanced age (hazard ratio (HR) = 1.06, 95% confidence interval (CI) = 1.01–1.11, p = 0.015), assistant-assisted peritoneal dialysis (PD; HR = 2.64, 95% CI = 1.23–5.64, p = 0.012), higher body mass index (BMI; HR = 1.11, 95% CI = 1.02–1.20, p = 0.010), and low serum albumin level (HR = 0.94, 95% CI = 0.90–0.98, p = 0.004) were associated with increased peritonitis risk in elderly patients. Compared with younger ones with peritonitis, elderly patients had an approximately fourfold increased risk of peritonitis-related mortality (odd ratio (OR) = 3.57, 95% CI = 1.38–9.28, p = 0.009). During the cohort, peritonitis was the risk factor associated with technique failure (HR = 3.19, 95% CI = 2.33–4.39, p < 0.001) in younger patient but not in the elderly population (HR = 1.82, 95% CI = 0.84–3.94, p = 0.132). Conclusions: Elderly PD patients had higher prevalence for peritonitis and peritonitis-related mortality. Advanced age, assistant-assisted PD, a higher BMI, and lower serum albumin level were independently associated with the first episode of peritonitis in elderly patients. However, peritonitis was not the predictor of death-censored technique failure in elderly ones.

Lower Serum Albumin Level Is Associated With an Increased Risk for Loss of Residual Kidney Function in Patients Receiving Peritoneal Dialysis

2019 ◽  
Vol 24 (1) ◽  
pp. 72-80 ◽  
Author(s):  
Shunsuke Yamada ◽  
Yasuhiro Kawai ◽  
Shoji Tsuneyoshi ◽  
Hiroaki Tsujikawa ◽  
Hokuto Arase ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Kidney Function ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Lower Serum ◽  
Residual Kidney Function ◽  
Increased Risk

Pulmonary Hypertension in Peritoneal Dialysis Patients: Prevalence and Risk Factors

2009 ◽  
Vol 29 (2) ◽  
pp. 191-198 ◽  
Author(s):  
Aydin Ünal ◽  
Murat Sipahioglu ◽  
Fatih Oguz ◽  
Mehmet Kaya ◽  
Hamit Kucuk ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Ejection Fraction ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Systolic Pulmonary Artery Pressure ◽  
Ventricular Ejection Fraction

Aim To investigate the prevalence of pulmonary arterial hypertension (PAH) and the possible contributing factors for PAH in patients receiving regular continuous ambulatory peritoneal dialysis (CAPD). Patients and Methods The study included 135 CAPD patients and 15 disease-free controls. Patients that had chronic obstructive pulmonary disease, severe mitral or aortic valve disease, connective tissue disease, history of pulmonary embolism, left ventricular ejection fraction <50%, or chest wall or parenchymal lung disease were excluded. All patients and controls were examined using echocardiography and bioelectrical impedance analysis. PAH was defined as systolic pulmonary artery pressure (PAP) >35 mmHg at rest. Results Mean systolic PAP was higher in the CAPD patients than in the controls (19.66 ± 11.66 vs 14.27 ± 4.55 mmHg, p = 0.001). PAH was detected in 17 (12.6%) of the 135 CAPD patients. Mean systolic PAP was significantly higher in patients with PAH than in those without PAH (42.00 ± 9.13 vs 16.44 ± 7.83 mmHg, p = 0.001). Serum albumin level and ejection fraction were lower in patients with PAH than in those without PAH ( p = 0.001 and 0.003 respectively). The ratio of extracellular water/total body water (ECW/TBW), which can reflect hydration status, was significantly higher in patients with PAH than in those without PAH ( p = 0.008). In the PD group, no patients were hypovolemic; 51 (37.8%) of the 135 PD patients were hypervolemic and 84 (62.2%) were normovolemic. Only 3 of the 17 patients with PAH were normovolemic; the rest were hypervolemic. Mean systolic PAP was significantly higher in hypervolemic PD patients (24.57 ± 14.19 mmHg) than in normovolemic PD patients (16.68 ± 7.61 mmHg) ( p = 0.001). PAP correlated with ECW/TBW ( r=0.317, p = 0.001) and left ventricular mass index (LVMI; r=0.286, p = 0.001). On the other hand, it inversely correlated with serum albumin level ( r = –0.281, p = 0.001), hemoglobin level ( r = –0.165, p = 0.044), and ejection fraction ( r = –0.263, p = 0.001). Serum albumin level, ECW/TBW, and LVMI were found in multivariate analysis to be independent risk factors for PAP. Conclusion PAH is a frequent cardiovascular complication in CAPD patients. Serum albumin level, hypervolemia, and LVMI are major risk factors for PAH. Therefore, strategies for treatment of hypervolemia, left ventricular hypertrophy, and hypoalbuminemia should be enhanced to prevent the development of PAH in CAPD patients.

Albumin and Amino Acid Levels as Markers of Adequacy in Continuous Ambulatory Peritoneal Dialysis

1994 ◽  
Vol 14 (3_suppl) ◽  
pp. 123-132 ◽  
Author(s):  
Olof Heimbürger ◽  
Jonas Bergström ◽  
Bengt Lindholm
Keyword(s):  
Peritoneal Dialysis ◽  
Amino Acid ◽  
Nutritional Status ◽  
Serum Albumin ◽  
Protein Intake ◽  
Serum Albumin Level ◽  
Strong Predictor ◽  
Albumin Level ◽  
Dialysis Dose ◽  
Small Solute

Similar to previous findings in HD patients, a markedly decreased serum albumin level has been found to be a strong predictor of morbidity and mortality in CAPD patients. However, a slight decrease in serum albumin levels (to about 30 g/L if measured with nephelometry or the bromcresol purple method) does not always seem to reflect impaired nutritional status or to be associated with an increased morbidity or mortality in CAPD patients. A low serum albumin level among CAPD patients is related to dialysate albumin loss, comorbidity, age, and a low dietary protein intake. The possible relation between the dialysis dose (as assessed by small solute clearances) and serum albumin levels among CAPD patients is much less established and needs further study, although serum albumin tends to increase in prospective studies of increased peritoneal dialysis dose. Although the plasma levels of amino acids seem to be lower in CAPD patients compared to HD patients, this does not reflect the intracellular amino acid pattern in muscle which is less abnormal in CAPD patients, possibly because of the sustained hyperinsulinemia during CAPD, resulting in an in creased intracellular to extracellular gradient. It is at present not established to what extent the amino acid abnormalities are related to the dialysis dose. Malnourished and hypoalbuminemic CAPD patients should be recommended to increase the protein intake, and if this is not effective, the dialysis dose should be increased. Furthermore, the use of amino acid-based peritoneal dialysis solutions is a promising new tool for the treatment of malnourished CAPD patients and may become an important component of CAPD therapy in the future. On the other hand, if the nutritional status deteriorates in spite of these efforts, the patient should be transferred to hemodialysis if possible.

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