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

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TitleMeasured-to-predicted creatinine generation ratio increases with time and decline in residual renal function in continuous ambulatory peritoneal dialysis
AuthorsSzeto, CC1
Lai, KN1
Wong, TYH1
Law, MC1
Li, PKT1
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
CitationAmerican Journal Of Kidney Diseases, 1999, v. 34 n. 2, p. 235-241 [How to Cite?]
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.
ISSN0272-6386
2011 Impact Factor: 5.434
2011 SCImago Journal Rankings: 0.407
ISI Accession Number IDWOS:000081955600007
DC Field
Value
dc.contributor.authorSzeto, CC
dc.contributor.authorLai, KN
dc.contributor.authorWong, TYH
dc.contributor.authorLaw, MC
dc.contributor.authorLi, PKT
dc.date.accessioned2010-09-06T07:28:47Z
dc.date.available2010-09-06T07:28:47Z
dc.date.issued1999
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.
dc.description.natureLink_to_subscribed_fulltext
dc.identifier.citationAmerican Journal Of Kidney Diseases, 1999, v. 34 n. 2, p. 235-241 [How to Cite?]
dc.identifier.epage241
dc.identifier.hkuros50637
dc.identifier.isiWOS:000081955600007
dc.identifier.issn0272-6386
2011 Impact Factor: 5.434
2011 SCImago Journal Rankings: 0.407
dc.identifier.issue2
dc.identifier.openurl
dc.identifier.pmid10430968
dc.identifier.scopuseid_2-s2.0-0032804237
dc.identifier.spage235
dc.identifier.urihttp://hdl.handle.net/10722/77147
dc.identifier.volume34
dc.languageeng
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/ajkd
dc.publisher.placeUnited States
dc.relation.ispartofAmerican Journal of Kidney Diseases
dc.subjectCompliance
dc.subjectCreatinine generation
dc.subjectPeritoneal dialysis
dc.subjectRenal failure
dc.titleMeasured-to-predicted creatinine generation ratio increases with time and decline in residual renal function in continuous ambulatory peritoneal dialysis
dc.typeArticle
Author Affiliations
  1. Prince of Wales Hospital Hong Kong