Document Detail


Peritoneal albumin and protein losses do not predict outcome in peritoneal dialysis patients.
MedLine Citation:
PMID:  21071518     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Peritoneal clearance of albumin-unlike the transport of small molecules-is defined by both vascular surface area and size-selective permeability. Few studies have supported a positive correlation between peritoneal albumin loss and mortality. The aim of this study was to investigate whether baseline peritoneal loss and clearance of albumin and other proteins is a risk factor of death in peritoneal dialysis patients.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: All incident peritoneal dialysis patients in our center during the last 15 years were included. Mass-transfer area coefficient of creatinine and peritoneal clearances of albumin, β₂-microglobulin, α₂-macroglobulin, and immunoglobulin G were calculated during a standard peritoneal permeability analysis. The total amount of albumin loss in the dialysate was also calculated. Overall mortality was studied with an intention-to-treat analysis.
RESULTS: Two hundred fifty-seven patients were included. High baseline albumin clearance was associated with fast transport status, the presence of peripheral arterial disease, and a high comorbidity index, whereas C-reactive protein levels did not differ from the patients with low albumin clearance. Age, high comorbidity score, C-reactive protein levels >10 mg/L, and a low serum albumin were associated with mortality. Peritoneal albumin clearances and albumin loss were not associated with death in crude and adjusted analysis. Similarly, peritoneal clearances of immunoglobulin G, α₂-macroglobulin, and β₂-microglobulin were not determinants of survival.
CONCLUSIONS: Baseline peritoneal albumin and protein clearances are associated with signs of comorbidity, but this does not have a measurable effect on patient survival.
Authors:
Olga Balafa; Nynke Halbesma; Dirk G Struijk; Friedo W Dekker; Raymond T Krediet
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Publication Detail:
Type:  Journal Article     Date:  2010-11-11
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:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  101271570     Medline TA:  Clin J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  561-6     Citation Subset:  IM    
Affiliation:
Department of Nephrology, Academic Medical Center, Amsterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Proteins / metabolism*
Chi-Square Distribution
Comorbidity
Female
Humans
Hypoalbuminemia / blood,  etiology,  mortality
Immunoglobulin G / metabolism
Kaplan-Meier Estimate
Male
Middle Aged
Netherlands
Peritoneal Dialysis / adverse effects,  mortality*
Peritoneum / metabolism*
Permeability
Proportional Hazards Models
Prospective Studies
Risk Assessment
Risk Factors
Serum Albumin / metabolism*
Survival Rate
Time Factors
Treatment Outcome
alpha-Macroglobulins / metabolism
beta 2-Microglobulin / metabolism
Chemical
Reg. No./Substance:
0/Blood Proteins; 0/Immunoglobulin G; 0/Serum Albumin; 0/alpha-Macroglobulins; 0/beta 2-Microglobulin
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