Document Detail


Suitable dialytic indicators for pediatric peritoneal dialysis patients: the alternative to creatinine clearance.
MedLine Citation:
PMID:  12938829     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Owing to the discord between body weight and body surface area (BSA), creatinine clearance (CCr) is predisposed to be small in pediatric patients on peritoneal dialysis (PD). Alternatively, Kt/V creatinine (Kt/V creat), which is normalized to total body water (TBW) rather than BSA, could be a better dialytic indicator. In this study, the efficiency of dialysis and the nutritional status of pediatric patients on chronic PD were examined, and the utility of dialytic indicators was evaluated. PATIENTS AND METHODS: 49 patients under 20 years old, in stable condition, and on PD were analyzed. Weekly total Kt/V of urea (Kt/V urea), CCr, Kt/V creat, and normalized protein equivalent of nitrogen appearance (nPNA) were measured for all patients and for patients under 6 years old. The target value was 2.0/week for Kt/V urea and 60 L/ week/1.73 m2 for CCr, as recommended by the Kidney Disease Outcomes Quality Initiative guidelines. The target value for Kt/V creat was set as 1.52/week, using a male model with a height of 170 cm and a body weight of 65 kg. RESULTS: The mean values of delivered Kt/V urea, CCr, Kt/V creat, and nPNA (and proportion of patients that achieved each target value) for all patients were 2.25 +/- 0.57/ week (67.4%), 53.8 +/- 19.3 L/week1/.73 m2 (26.5%), 1.83 +/- 0.73/ week (65.3%), and 1.11 +/- 0.42 g/day, respectively. The values for patients under 6 years old were 2.38 +/- 0.26/week (90.0%), 45.9 +/- 12.8 L/week/1.73 m2 (10.0%), 1.94 +/- 0.51/week (90.0%), and 1.52 +/- 0.67 g/day, respectively. Stepwise multiple regression analyses revealed that the relationship between CCr and Kt/V urea was affected by the patient's age. CONCLUSIONS: Our pediatric patients achieved the recommended target value of Kt/V urea. At the same time, the nPNA results reflected the patient's status well. However, CCr appeared to be inappropriate as an indicator for patients under 6 years old. Kt/V creat is suggested to be a better dialytic indicator for these patients.
Authors:
Kenji Ishikura; Hiroshi Hataya; Masahiro Ikeda; Masataka Honda
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis     Volume:  23     ISSN:  0896-8608     ISO Abbreviation:  Perit Dial Int     Publication Date:    2003 May-Jun
Date Detail:
Created Date:  2003-08-26     Completed Date:  2004-01-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8904033     Medline TA:  Perit Dial Int     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  270-5     Citation Subset:  IM    
Affiliation:
Department of Pediatric Nephrology, Tokyo Metropolitan Children's Hospital, Tokyo, Japan. ishikura@chp-kiyose-tokyo.jp
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Age Factors
Body Surface Area*
Body Water*
Body Weight*
Child
Creatinine / metabolism*
Female
Humans
Kidney Failure, Chronic / therapy
Male
Metabolic Clearance Rate
Nutritional Status*
Peritoneal Dialysis*
Reproducibility of Results
Treatment Outcome
Chemical
Reg. No./Substance:
60-27-5/Creatinine

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


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