Document Detail


Decline in residual renal function in automated compared with continuous ambulatory peritoneal dialysis.
MedLine Citation:
PMID:  21393494     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: We compared the decline of RRF in patients starting dialysis on APD with those starting on CAPD, because a faster decline on APD has been suggested.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: NECOSAD patients starting dialysis on APD or CAPD with RRF at baseline were included and followed for 3 years. Residual GFR (rGFR) was the mean of urea and creatinine clearances. Differences in yearly decline of rGFR were estimated in analyses with linear repeated measures models, whereas the risk of complete loss of RRF was estimated by calculating hazard ratios (HRs) for APD compared with CAPD. As-treated (AT) and intention-to-treat (ITT) designs were used. All of the analyses were adjusted for age, gender, comorbidity, and primary kidney disease and stratified according to follow-up and mean baseline GFR.
RESULTS: The 505 CAPD and 78 APD patients had no major baseline differences. No differences were found in the analyses on yearly decline of rGFR. APD patients did have a higher risk of losing RRF in the first year (ITT crude HR 2.43 [confidence interval 95%, 1.48 to 4.00], adjusted 2.66 [1.60 to 4.44]; AT crude 1.89 [1.04 to 3.45], adjusted 2.15 [1.16 to 3.98]). The higher risk of losing all RRF was most pronounced in patients with the highest rGFR at baseline (ITT; crude 3.91 [1.54 to 9.94], adjusted 1.85 to 14.17).
CONCLUSIONS: The risk of losing RRF is higher for patients starting dialysis on APD compared with those starting on CAPD, especially in the first year.
Authors:
Wieneke Marleen Michels; Marion Verduijn; Diana C Grootendorst; Saskia le Cessie; Elisabeth Wilhelmina Boeschoten; Friedo Wilhelm Dekker; Raymond Theodorus Krediet;
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2011-03-10
Journal Detail:
Title:  Clinical journal of the American Society of Nephrology : CJASN     Volume:  6     ISSN:  1555-905X     ISO Abbreviation:  Clin J Am Soc Nephrol     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-17     Completed Date:  2011-06-30     Revised Date:  2012-03-01    
Medline Journal Info:
Nlm Unique ID:  101271570     Medline TA:  Clin J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  537-42     Citation Subset:  IM    
Affiliation:
Division of Nephrology, Department of Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. w.m.michels@amc.uva.nl
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Automation
Chi-Square Distribution
Female
Glomerular Filtration Rate*
Humans
Kidney / physiopathology*
Kidney Diseases / diagnosis,  physiopathology,  therapy*
Linear Models
Male
Middle Aged
Netherlands
Peritoneal Dialysis / adverse effects,  methods*
Peritoneal Dialysis, Continuous Ambulatory* / adverse effects
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Investigator
Investigator/Affiliation:
A J Apperloo / ; J A Bijlsma / ; M Boekhout / ; W H Boer / ; P J M van der Boog / ; H R Büller / ; M van Buren / ; F T de Charro / ; C J Doorenbos / ; M A van den Dorpel / ; A van Es / ; W J Fagel / ; G W Feith / ; C W H de Fijter / ; L A M Frenken / ; W Grave / ; J A C A van Geelen / ; P G G Gerlag / ; J P M C Gorgels / ; R M Huisman / ; K J Jager / ; K Jie / ; W A H Koning-Mulder / ; M I Koolen / ; T K Kremer Hovinga / ; A T J Lavrijssen / ; A J Luik / ; J van der Meulen / ; K J Parlevliet / ; M H M Raasveld / ; F M van der Sande / ; M J M Schonck / ; M M J Schuurmans / ; C E H Siegert / ; C A Stegeman / ; P Stevens / ; J G P Thijssen / ; R M Valentijn / ; G H Vastenburg / ; C A Verburgh / ; H H Vincent / ; P F Vos /

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