Document Detail


Relationship between residual renal function, inflammation, and anemia in peritoneal dialysis.
MedLine Citation:
PMID:  17886621     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In peritoneal dialysis (PD) patients, we analyzed the relationship between residual renal function (RRF) and well-known predictors of mortality such as anemia, inflammation, and nutrition. We also investigated possible associations between the foregoing parameters and cardiovascular comorbidity, peritoneal transport rate, statin and antihypertensive treatments, and ultrafiltration volume. Our study enrolled 24 patients (17 men, 7 women; mean age: 56 +/- 12 years) who had started PD at our hospital between 1998 and 2004. Patients who had been hospitalized or had had peritonitis before the study were excluded. Nutrition status, inflammation, anemia, RRF and dialysis adequacy were assessed after 1-2 months. We found that RRF was positively correlated with normalized protein equivalent of nitrogen appearance (nPNA: r = 0. 52, p = 0. 03) and negatively correlated with C-reactive protein (CRP: r = -0.47, p < 0.01) and peritoneal ultrafiltration (r = -0.42, p < 0.05). Only the nPNA and CRP correlations remained statistically significant on multivariate logistic regression analysis (CRP: r = 0.8, p = 0.011; nPNA: p = 0.013). Moreover, as compared with patients without inflammation, patients with inflammation had significantly lower hemoglobin (Hgb) levels (11.8 +/- 1.1 g/dL vs. 13.2 +/- 1.2 g/dL, p < 0.02), serum prealbumin levels (27.3 +/- 8 mg/dL vs. 36.6 +/- 9 mg/dL, p < 0.05), and serum transferrin levels (168 +/- 34 mg/dL vs. 202 +/- 31 mg/dL, p < 0.05), and a higher erythropoietin resistance index (ERI: 10 +/- 4 vs. 6 +/- 3.5, p < 0. 02). We observed no differences in RRF or nutrition status between the patients with high and with low peritoneal transport. Regarding comorbidity, patients with pre-existing cardiovascular disease had higher CRP levels (0.8 +/- 0.4 mg/dL vs. 0.4 +/- 0.4 mg/dL, p < 0.05) and lower mean Hgb levels (13.3 +/- 1 g/dL vs. 14.4 +/- 1 g/dL, p < 0.05) than did patients without such pre-existing disease. A strong, predictable association exists between RRF and inflammation and nutrition status in incident patients on PD. Serum CRP is a good indicator of inflammation, which correlates well with nutrition status, anemia, and responsiveness to erythropoietin therapy.
Authors:
Isabel Pérez-Flores; Francisco Coronel; Secundino Cigarrán; José A Herrero; Natividad Calvo
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Advances in peritoneal dialysis. Conference on Peritoneal Dialysis     Volume:  23     ISSN:  1197-8554     ISO Abbreviation:  Adv Perit Dial     Publication Date:  2007  
Date Detail:
Created Date:  2007-09-24     Completed Date:  2007-11-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9104803     Medline TA:  Adv Perit Dial     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  140-3     Citation Subset:  IM    
Affiliation:
Nephrology Department, Hospital Clinico San Carlos, Madrid, Spain. impeflo1@mi.madritel.es
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MeSH Terms
Descriptor/Qualifier:
Anemia / etiology*
C-Reactive Protein / analysis
Female
Humans
Inflammation
Kidney / physiopathology*
Kidney Failure, Chronic / complications,  physiopathology*,  therapy
Male
Middle Aged
Nutritional Status
Peritoneal Dialysis*
Prealbumin / analysis
Transferrin / analysis
Chemical
Reg. No./Substance:
0/Prealbumin; 11096-37-0/Transferrin; 9007-41-4/C-Reactive Protein

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