Document Detail

Derived equations are not precise enough to predict the adequacy of creatinine clearance in peritoneal dialysis patients.
MedLine Citation:
PMID:  12407650     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Most renal units assess dialysis adequacy in peritoneal dialysis (PD) patients by formal 24-hour collections of urine and effluent dialysate. We sought a reliable method of predicting dialysis adequacy that allows a decrease in the frequency of these formal and cumbersome measurements. METHODS: We created a formula for estimating total creatinine clearances, then assessed the clinical utility of this formula and other published formulae in predicting adequate and inadequate dialysis in PD patients. We collected data over a 6-month period in 2001 from 288 PD patients from 9 centers in Scotland. Four out of every 5 patients were selected at random to create a formula for estimating total creatinine clearance per week, and the fifth patient was used to form a validation group. We plotted creatinine excretion against age, and the resultant linear regression equation was transformed to produce a formula for predicting total creatinine clearance per week, based on patient sex, weight, and serum creatinine. We used the data from the validation subgroup to calculate predictive values for our derived formula and data from all of the patients to calculate predictive values for the Cockcroft and Gault, Jones, and Modification of Diet in Renal Disease Study formulae. RESULTS: Neither our derived formula nor the three published formulae were sufficiently powerful to predict accurately either adequate or inadequate PD clearance. Receiver operator characteristic curves showed that no significant improvement in these predictive values could be achieved by altering either the sensitivity or the specificity. CONCLUSION: Prediction formulae are not accurate enough to detect underdialysis in PD patients.
Jamie P Traynor; Siobhan K McManus; Robert A Mactier;
Publication Detail:
Type:  Journal Article; Validation Studies    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  40     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-10-30     Completed Date:  2002-12-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1036-44     Citation Subset:  IM    
Copyright Information:
Copyright 2002 by the National Kidney Foundation, Inc.
Renal Unit, Glasgow Royal Infirmary and Western Infirmary, Glasgow, Scotland, United Kingdom.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Aged, 80 and over
Creatinine / blood,  metabolism*,  urine
Kidney Diseases / blood,  therapy
Linear Models
Middle Aged
Models, Biological*
Peritoneal Dialysis / methods*
Predictive Value of Tests
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Relapsing culture-negative peritonitis in peritoneal dialysis patients exposed to icodextrin solutio...
Next Document:  Effect of diabetes on peritoneal function assessed by personal dialysis capacity test in patients un...