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PREDICTORS OF RESIDUAL RENAL FUNCTION DECLINE IN PATIENTS UNDERGOING CONTINUOUS AMBULATORY PERITONEAL DIALYSIS.
MedLine Citation:
PMID:  24497594     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Residual renal function (RRF) is an important prognostic indicator in continuous ambulatory peritoneal dialysis (CAPD) patients. We determined the predictors of RRF loss in a cohort of incident CAPD patients.
METHODS: We reviewed the record of 645 incident CAPD patients. RRF loss is represented by the slope of decline of residual glomerular filtration rate (GFR) as well as the time to anuria.
RESULTS: The average rate of residual GFR decline was -0.083 ± 0.094 mL/min/month. The rate of residual GFR decline was faster with a higher proteinuria (r = -0.506, p < 0.0001) and baseline residual GFR (r = -0.560, p < 0.0001). Multivariate analysis showed that proteinuria, baseline residual GFR, and the use of diuretics were independent predictors of residual GFR decline. Cox proportional hazard model showed that proteinuria, glucose exposure, and the number of peritonitis episodes were independent predictors of progression to anuria, while a higher baseline GFR was protective. Each 1 g/day of proteinuria is associated with a 13.2% increase in the risk of progressing to anuria, each 10g/day higher glucose exposure is associated with a 2.5% increase in risk, while each peritonitis episode confers a 3.8% increase in risk.
CONCLUSIONS: Our study shows that factors predicting the loss of residual solute clearance and urine output are different. Proteinuria, baseline residual GFR, and the use of diuretics are independently related to the rate of RRF decline in CAPD patients, while proteinuria, glucose exposure, and the number of peritonitis episodes are independent predictors for the development of anuria. The role of anti-proteinuric therapy and measures to prevent peritonitis episodes in the preservation of RRF should be tested in future studies.
Authors:
Cheuk-Chun Szeto; Bonnie C Kwan; Kai-Ming Chow; Sebastian Chung; Vincent Yu; Mei-Shan Cheng; Chi-Bon Leung; Man-Ching Law; Phillip K Li
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-2-4
Journal Detail:
Title:  Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis     Volume:  -     ISSN:  1718-4304     ISO Abbreviation:  Perit Dial Int     Publication Date:  2014 Feb 
Date Detail:
Created Date:  2014-2-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8904033     Medline TA:  Perit Dial Int     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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