Document Detail


Daily peritoneal ultrafiltration predicts patient and technique survival in anuric peritoneal dialysis patients.
MedLine Citation:
PMID:  20118483     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Maintenance dialysis therapy is the only way to remove excess fluid in patients with anuric end-stage renal disease. The optimal ultrafiltration (UF) volume in patients on peritoneal dialysis (PD) remains controversial. METHODS: We retrospectively analysed a cohort of 86 prevalent anuric PD patients followed up for a median of 25.3 months (range, 6 to 54 months). Clinical and PD parameters were recorded yearly. Kaplan-Meier analysis and Cox proportional hazards models were used to identify risk factors of mortality and technique failure in patients with a UF >/=1 L/24 h or <1 L/24 h. RESULTS: When compared to those with a UF <1 L/24 h, patients with a UF >/=1 L/24 h had significantly higher haemoglobin levels (101.9 +/- 20.5 vs 89.3 +/- 20.2 g/L, P < 0.05) and tended to be younger (55.0 +/- 12.5 vs 60.6 +/- 16.1 years, P = 0.10). Also, while Kt/V and CCr were stable over time, UF decreased significantly over the study period (baseline, 1205.5 +/- 327.3 ml/24 h vs after 3 years, 870.6 +/- 439.8 ml/24 h; P < 0.001). Using Kaplan-Meier analysis, patients with baseline UF <1 L/24 h had significantly worse outcome (survival, 27.2 +/- 3.9 vs 42.4 +/- 1.9 months; P < 0.001). In multivariate Cox regression analysis, age, time-dependent UF volume and serum albumin were independent predictors of mortality, while UF independently predicted technique failure. CONCLUSIONS: The present study demonstrates a strong predictive value of daily peritoneal UF for both technique and patient survival in prevalent anuric PD patients. Identifying markers of satisfactory fluid status, as well as optimizing therapy to meet UF goals, remains an important clinical target.
Authors:
Xinghui Lin; Aiwu Lin; Zhaohui Ni; Qiang Yao; Weiming Zhang; Yucheng Yan; Wei Fang; Aiping Gu; Jonas Axelsson; Jiaqi Qian
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Publication Detail:
Type:  Journal Article     Date:  2010-01-29
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  25     ISSN:  1460-2385     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-25     Completed Date:  2010-11-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  2322-7     Citation Subset:  IM    
Affiliation:
Renal Division, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Center for Peritoneal Dialysis Research, Shanghai, China.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anuria / metabolism,  mortality*,  therapy*
China
Cohort Studies
Female
Humans
Kaplan-Meiers Estimate
Kidney Failure, Chronic / metabolism,  mortality*,  therapy*
Male
Middle Aged
Peritoneal Dialysis / methods*
Predictive Value of Tests
Regression Analysis
Retrospective Studies
Risk Factors
Serum Albumin / metabolism
Treatment Outcome
Ultrafiltration / methods*
Chemical
Reg. No./Substance:
0/Serum Albumin

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