Document Detail

Effect of fluid and sodium removal on mortality in peritoneal dialysis patients.
MedLine Citation:
PMID:  11473661     Owner:  NLM     Status:  MEDLINE    
Effect of fluid and sodium removal on mortality in peritoneal dialysis patients. BACKGROUND: Adequacy of peritoneal dialysis (PD) traditionally is assessed using Kt/V(urea) and total creatinine clearance (TCC). However, this approach underestimates the importance of fluid and sodium removal. The aim of this study was to determine the effect of fluid and sodium removal on morbidity and mortality in PD patients. METHODS: One hundred twenty-five PD patients were monitored for three years from the beginning of the treatment. The effects of demographic features, comorbidity, peritonitis rate, blood pressure, medications, blood biochemistry, peritoneal membrane transport characteristics, residual renal function (RRF), Kt/V(urea), TCC, normalized protein nitrogen appearance (nPNA), and removal of sodium and fluid on mortality were evaluated. Total and cardiovascular hospitalization rates were also recorded. A Cox proportional hazards model was used to determine factors predicting mortality. RESULTS: In the Cox model, comorbidity, total sodium and fluid removals, hypertensive status, serum creatinine, and RRF were independent factors affecting survival. In contrast, Kt/V(urea) or TCC did not affect the adjusted survivals. Total sodium and fluid removal and hypertensive status also significantly influenced the hospitalization rate. Systolic and diastolic blood pressures were negatively correlated with total fluid (P < 0.001) and sodium removal (P < 0.001). CONCLUSIONS: Together, these findings suggest that removal of sodium and fluid is a predictor of mortality in PD patients, whereas Kt/V(urea) and TCC are not factors. Adequate fluid and sodium balance is crucial for the management of patients on PD.
K Ateş; G Nergizoğlu; K Keven; A Sen; S Kutlay; S Ertürk; N Duman; O Karatan; A E Ertuğ
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Kidney international     Volume:  60     ISSN:  0085-2538     ISO Abbreviation:  Kidney Int.     Publication Date:  2001 Aug 
Date Detail:
Created Date:  2001-07-27     Completed Date:  2001-10-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  767-76     Citation Subset:  IM    
Ankara University Medical School, Ibn-i Sina Hospital, Department of Nephrology, Ankara, Turkey.
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MeSH Terms
Blood Pressure
Body Fluids / metabolism*
Creatinine / blood
Dialysis Solutions / pharmacokinetics
Follow-Up Studies
Hypertension, Renal / metabolism,  mortality,  therapy
Kidney / physiology
Kidney Failure, Chronic / metabolism,  mortality*,  therapy*
Middle Aged
Peritoneal Dialysis / mortality*
Peritoneum / metabolism
Proportional Hazards Models
Sodium / metabolism*
Treatment Outcome
Reg. No./Substance:
0/Dialysis Solutions; 60-27-5/Creatinine; 7440-23-5/Sodium
Comment In:
Kidney Int. 2002 Apr;61(4):1552   [PMID:  11918771 ]

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