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Article: Effect of Kt/V on survival and clinical outcome in CAPD patients in a randomized prospective study

TitleEffect of Kt/V on survival and clinical outcome in CAPD patients in a randomized prospective study
Authors
Issue Date2003
PublisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ki/index.html
Citation
Kidney International, 2003, v. 64 n. 2, p. 649-656 How to Cite?
AbstractBackground. There has been a lack of randomized control study on the effect of Kt/V on patient outcome. This interventional study was designed to examine the effect of Kt/V on continuous ambulatory peritoneal dialysis (CAPD) patients' clinical outcome and nutritional status in a randomized prospective manner. Method. A total of 320 new CAPD patients with baseline renal Kt/V <1.0 were recruited from six centers in Hong Kong and were randomized into three Kt/V targets: group A, 1.5 to 1.7; group B, 1.7 to 2.0; and group C, >2.0. Kt/V and nutritional status were assessed every 6 months and dialysis prescription adjusted accordingly. Nutritional assessment included serum albumin and composite nutritional index (CNI). Patients were allowed to withdraw at the discretion of their physicians or themselves. Results. Total Kt/V were significantly different between groups (P = 0.000) and the difference was contributed by peritoneal Kt/V only. The overall 2-year patient survival was 84.9%. There was no statistical difference in patient survival among the three groups (2-year survival in group A, 87.3%; group B, 86.1%; and group C, 81.5%). However, there were more patients withdrawn by physicians in group A (group A, 16; group B, 7; and group C, 6; P = 0.023). Total Kt/V or Kt did not significantly affect survival after adjustment to age and diabetes. There was no difference in serum albumin, CNI scores, and hospitalization rate, but there were more patients in group A requiring erythropoietin (EPO) treatment after 1 year. Conclusion. Patients with total Kt/V maintained below 1.7 had significantly more clinical problems and severe anemia but there was no difference in outcome demonstrated for patients with Kt/V maintained above 2.0 and between 1.7 and 2.0. We recommended that the minimal target of total Kt/V should be above 1.7.
Persistent Identifierhttp://hdl.handle.net/10722/78162
ISSN
2015 Impact Factor: 7.683
2015 SCImago Journal Rankings: 3.181
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLo, WKen_HK
dc.contributor.authorHo, YWen_HK
dc.contributor.authorLi, CSen_HK
dc.contributor.authorWong, KSen_HK
dc.contributor.authorChan, TMen_HK
dc.contributor.authorYu, AWYen_HK
dc.contributor.authorNg, FSKen_HK
dc.contributor.authorCheng, IKPen_HK
dc.date.accessioned2010-09-06T07:39:51Z-
dc.date.available2010-09-06T07:39:51Z-
dc.date.issued2003en_HK
dc.identifier.citationKidney International, 2003, v. 64 n. 2, p. 649-656en_HK
dc.identifier.issn0085-2538en_HK
dc.identifier.urihttp://hdl.handle.net/10722/78162-
dc.description.abstractBackground. There has been a lack of randomized control study on the effect of Kt/V on patient outcome. This interventional study was designed to examine the effect of Kt/V on continuous ambulatory peritoneal dialysis (CAPD) patients' clinical outcome and nutritional status in a randomized prospective manner. Method. A total of 320 new CAPD patients with baseline renal Kt/V <1.0 were recruited from six centers in Hong Kong and were randomized into three Kt/V targets: group A, 1.5 to 1.7; group B, 1.7 to 2.0; and group C, >2.0. Kt/V and nutritional status were assessed every 6 months and dialysis prescription adjusted accordingly. Nutritional assessment included serum albumin and composite nutritional index (CNI). Patients were allowed to withdraw at the discretion of their physicians or themselves. Results. Total Kt/V were significantly different between groups (P = 0.000) and the difference was contributed by peritoneal Kt/V only. The overall 2-year patient survival was 84.9%. There was no statistical difference in patient survival among the three groups (2-year survival in group A, 87.3%; group B, 86.1%; and group C, 81.5%). However, there were more patients withdrawn by physicians in group A (group A, 16; group B, 7; and group C, 6; P = 0.023). Total Kt/V or Kt did not significantly affect survival after adjustment to age and diabetes. There was no difference in serum albumin, CNI scores, and hospitalization rate, but there were more patients in group A requiring erythropoietin (EPO) treatment after 1 year. Conclusion. Patients with total Kt/V maintained below 1.7 had significantly more clinical problems and severe anemia but there was no difference in outcome demonstrated for patients with Kt/V maintained above 2.0 and between 1.7 and 2.0. We recommended that the minimal target of total Kt/V should be above 1.7.en_HK
dc.languageengen_HK
dc.publisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ki/index.htmlen_HK
dc.relation.ispartofKidney Internationalen_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshFemaleen_HK
dc.subject.meshFollow-Up Studiesen_HK
dc.subject.meshHemoglobinsen_HK
dc.subject.meshHospitalization - statistics & numerical dataen_HK
dc.subject.meshHumansen_HK
dc.subject.meshKidney Failure, Chronic - mortality - therapyen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshNutrition Assessmenten_HK
dc.subject.meshPeritoneal Dialysis, Continuous Ambulatory - mortalityen_HK
dc.subject.meshProspective Studiesen_HK
dc.subject.meshSurvival Analysisen_HK
dc.titleEffect of Kt/V on survival and clinical outcome in CAPD patients in a randomized prospective studyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0085-2538&volume=64&issue=2&spage=649&epage=656&date=2003&atitle=Effect+of+Kt/V+on+survival+and+clinical+outcome+in+CAPD+patients+in+a+randomized+prospective+studyen_HK
dc.identifier.emailChan, TM:dtmchan@hku.hken_HK
dc.identifier.authorityChan, TM=rp00394en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1046/j.1523-1755.2003.00098.xen_HK
dc.identifier.pmid12846762-
dc.identifier.scopuseid_2-s2.0-0038796391en_HK
dc.identifier.hkuros81843en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0038796391&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume64en_HK
dc.identifier.issue2en_HK
dc.identifier.spage649en_HK
dc.identifier.epage656en_HK
dc.identifier.isiWOS:000183966500029-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridLo, WK=7201502414en_HK
dc.identifier.scopusauthoridHo, YW=7402555047en_HK
dc.identifier.scopusauthoridLi, CS=36068236000en_HK
dc.identifier.scopusauthoridWong, KS=8079870700en_HK
dc.identifier.scopusauthoridChan, TM=7402687700en_HK
dc.identifier.scopusauthoridYu, AWY=7401478900en_HK
dc.identifier.scopusauthoridNg, FSK=7103125634en_HK
dc.identifier.scopusauthoridCheng, IKP=7102537483en_HK
dc.identifier.citeulike2941008-

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