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Article: Measured-to-predicted creatinine generation ratio increases with time and decline in residual renal function in continuous ambulatory peritoneal dialysis

TitleMeasured-to-predicted creatinine generation ratio increases with time and decline in residual renal function in continuous ambulatory peritoneal dialysis
Authors
KeywordsCompliance
Creatinine generation
Peritoneal dialysis
Renal failure
Issue Date1999
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/ajkd
Citation
American Journal Of Kidney Diseases, 1999, v. 34 n. 2, p. 235-241 How to Cite?
Abstract
The expression of measured-to-predicted creatinine generation ratio (M/P) has been proposed as an index of compliance in continuous ambulatory peritoneal dialysis (CAPD) patients. Although M/P may not be sensitive enough for cross-sectional study, serial monitoring has been suggested to identify noncompliance. We attempted to evaluate serial changes of M/P from a nonselected group of CAPD patients. Sixty-three patients, all followed up for 2 years, were reviewed retrospectively. Their M/P ratios at years 0 and 2 were computed and compared. Baseline M/P had a normal distribution with a mean of 0.96 ± 0.26. There was significant correlation between baseline M/P and residual glomerular filtration rate (GFR; r = -0.81; P < 0.0001). There were weak correlations between M/P and duration of dialysis (r = 0.52; P < 0.0001), body weight (r = -0.52; P < 0.0001), Kt/V (r = 0.31; P < 0.02), weekly creatinine clearance normalized to body surface area (r = 0.53; P < 0.0001), and serum albumin level (r = -0.28; P < 0.05). After 2 years, M/P increased in 56 of 63 patients (88.9%). Average M/P increased from 0.96 ± 0.26 to 1.31 ± 0.27 (P < 0.0001). Multivariant analysis showed M/P at year 0, which was largely determined by residual GFR, was the only independent factor affecting increase in M/P from year 0 to year 2. The general trend of increasing M/P was still present when only anuric patients were analyzed, although that was not statistically significant (1.21 ± 0.14 to 1.32 ± 0.24; P = 0.12). The finding of increasing M/P with time in CAPD patients, particularly those with significant residual renal function, suggests M/P may not be a reliable indicator of noncompliance, even for serial follow-up of the same patient. Better methods for assessment of compliance in CAPD patients are required.
Persistent Identifierhttp://hdl.handle.net/10722/77147
ISSN
2013 Impact Factor: 5.756
ISI Accession Number ID

 

Author Affiliations
  1. Prince of Wales Hospital Hong Kong
DC FieldValueLanguage
dc.contributor.authorSzeto, CCen_HK
dc.contributor.authorLai, KNen_HK
dc.contributor.authorWong, TYHen_HK
dc.contributor.authorLaw, MCen_HK
dc.contributor.authorLi, PKTen_HK
dc.date.accessioned2010-09-06T07:28:47Z-
dc.date.available2010-09-06T07:28:47Z-
dc.date.issued1999en_HK
dc.identifier.citationAmerican Journal Of Kidney Diseases, 1999, v. 34 n. 2, p. 235-241en_HK
dc.identifier.issn0272-6386en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77147-
dc.description.abstractThe expression of measured-to-predicted creatinine generation ratio (M/P) has been proposed as an index of compliance in continuous ambulatory peritoneal dialysis (CAPD) patients. Although M/P may not be sensitive enough for cross-sectional study, serial monitoring has been suggested to identify noncompliance. We attempted to evaluate serial changes of M/P from a nonselected group of CAPD patients. Sixty-three patients, all followed up for 2 years, were reviewed retrospectively. Their M/P ratios at years 0 and 2 were computed and compared. Baseline M/P had a normal distribution with a mean of 0.96 ± 0.26. There was significant correlation between baseline M/P and residual glomerular filtration rate (GFR; r = -0.81; P < 0.0001). There were weak correlations between M/P and duration of dialysis (r = 0.52; P < 0.0001), body weight (r = -0.52; P < 0.0001), Kt/V (r = 0.31; P < 0.02), weekly creatinine clearance normalized to body surface area (r = 0.53; P < 0.0001), and serum albumin level (r = -0.28; P < 0.05). After 2 years, M/P increased in 56 of 63 patients (88.9%). Average M/P increased from 0.96 ± 0.26 to 1.31 ± 0.27 (P < 0.0001). Multivariant analysis showed M/P at year 0, which was largely determined by residual GFR, was the only independent factor affecting increase in M/P from year 0 to year 2. The general trend of increasing M/P was still present when only anuric patients were analyzed, although that was not statistically significant (1.21 ± 0.14 to 1.32 ± 0.24; P = 0.12). The finding of increasing M/P with time in CAPD patients, particularly those with significant residual renal function, suggests M/P may not be a reliable indicator of noncompliance, even for serial follow-up of the same patient. Better methods for assessment of compliance in CAPD patients are required.en_HK
dc.languageengen_HK
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/ajkden_HK
dc.relation.ispartofAmerican Journal of Kidney Diseasesen_HK
dc.subjectComplianceen_HK
dc.subjectCreatinine generationen_HK
dc.subjectPeritoneal dialysisen_HK
dc.subjectRenal failureen_HK
dc.titleMeasured-to-predicted creatinine generation ratio increases with time and decline in residual renal function in continuous ambulatory peritoneal dialysisen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0272-6386&volume=34&issue=2&spage=235&epage=241&date=1999&atitle=Measured-to-predicted+creatinine+generation+ratio+increases+with+time+and+decline++in+residual+renal+function+in+continuous+ambulatory+peritoneal+dialysisen_HK
dc.identifier.emailLai, KN: knlai@hku.hken_HK
dc.identifier.authorityLai, KN=rp00324en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid10430968en_HK
dc.identifier.scopuseid_2-s2.0-0032804237en_HK
dc.identifier.hkuros50637en_HK
dc.identifier.volume34en_HK
dc.identifier.issue2en_HK
dc.identifier.spage235en_HK
dc.identifier.epage241en_HK
dc.identifier.isiWOS:000081955600007-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridSzeto, CC=35495407200en_HK
dc.identifier.scopusauthoridLai, KN=7402135706en_HK
dc.identifier.scopusauthoridWong, TYH=7403531489en_HK
dc.identifier.scopusauthoridLaw, MC=7202652927en_HK
dc.identifier.scopusauthoridLi, PKT=25928016800en_HK

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