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Article: Minimal and optimal peritoneal Kt/V targets: Results of an anuric peritoneal dialysis patient's survival analysis
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TitleMinimal and optimal peritoneal Kt/V targets: Results of an anuric peritoneal dialysis patient's survival analysis
 
AuthorsLo, WK1 2
Lui, SL1
Chan, TM1
Li, FK1
Lam, MF1
Tse, KC1
Tang, SCW1
Choy, CBY1
Lai, KN1
 
KeywordsKt/V
Minimal
Optimal
Peritoneal dialysis
Survival
Target
 
Issue Date2005
 
PublisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ki/index.html
 
CitationKidney International, 2005, v. 67 n. 5, p. 2032-2038 [How to Cite?]
DOI: http://dx.doi.org/10.1111/j.1523-1755.2005.00305.x
 
AbstractBackground. Residual renal clearance has been shown to be much more predictive of survival than peritoneal clearance. There has been little data to support a target level of peritoneal clearance. A retrospective study was therefore conducted to see how the peritoneal Kt/V had affected the survival of anuric patients in our center. Methods. Over a period of 10 years, there were 150 peritoneal dialysis patients with documented anuria. Their survival was analyzed according to their baseline peritoneal Kt/V at the time of documentation of anuria and at the time of their latest altered peritoneal dialysis (PD) prescription (subsequent Kt/V). Results. There were 90 females and 42 diabetics. The mean age and duration of dialysis were 57.7 ± 14.7 and 44.1 ± 31.3 months, respectively. The 2-year and 5-year survival rates were 88.7% and 66.7%, respectively. We found that patients with baseline peritoneal Kt/V below 1.67 had poorer survival after the documentation of anuria than those above [relative risk (RR) 1.985, P = 0.01], although the baseline Kt/V was not an independent risk factors in the whole group of patients. However, such effect was mainly observed in female patients. The survival was identical between those with Kt/V above or below 1.80 (P = 0.98). Among female patients, the group with baseline Kt/V 1.67 to 1.86 had the best survival, followed by those greater than 1.86 and lowest in those below 1.67 (P = 0.0016). For patients with baseline Kt/V below 1.80, those with subsequent Kt/V above 1.76 had better survival than those below (P = 0.033). Conclusion. Our data suggested that a negative effect of peritoneal Kt/V on survival is apparent at a level below 1.67 and there exists a limit of its effect at around 1.80. We suggested a minimal Kt/V target of 1.70 and an optimal target at 1.80 in anuric patients based on survival data. Prospective randomized study is required to confirm this finding. © 2005 by the International Society of Nephrology.
 
ISSN0085-2538
2012 Impact Factor: 7.916
2012 SCImago Journal Rankings: 2.697
 
DOIhttp://dx.doi.org/10.1111/j.1523-1755.2005.00305.x
 
ISI Accession Number IDWOS:000228582900051
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorLo, WK
 
dc.contributor.authorLui, SL
 
dc.contributor.authorChan, TM
 
dc.contributor.authorLi, FK
 
dc.contributor.authorLam, MF
 
dc.contributor.authorTse, KC
 
dc.contributor.authorTang, SCW
 
dc.contributor.authorChoy, CBY
 
dc.contributor.authorLai, KN
 
dc.date.accessioned2010-09-06T07:44:41Z
 
dc.date.available2010-09-06T07:44:41Z
 
dc.date.issued2005
 
dc.description.abstractBackground. Residual renal clearance has been shown to be much more predictive of survival than peritoneal clearance. There has been little data to support a target level of peritoneal clearance. A retrospective study was therefore conducted to see how the peritoneal Kt/V had affected the survival of anuric patients in our center. Methods. Over a period of 10 years, there were 150 peritoneal dialysis patients with documented anuria. Their survival was analyzed according to their baseline peritoneal Kt/V at the time of documentation of anuria and at the time of their latest altered peritoneal dialysis (PD) prescription (subsequent Kt/V). Results. There were 90 females and 42 diabetics. The mean age and duration of dialysis were 57.7 ± 14.7 and 44.1 ± 31.3 months, respectively. The 2-year and 5-year survival rates were 88.7% and 66.7%, respectively. We found that patients with baseline peritoneal Kt/V below 1.67 had poorer survival after the documentation of anuria than those above [relative risk (RR) 1.985, P = 0.01], although the baseline Kt/V was not an independent risk factors in the whole group of patients. However, such effect was mainly observed in female patients. The survival was identical between those with Kt/V above or below 1.80 (P = 0.98). Among female patients, the group with baseline Kt/V 1.67 to 1.86 had the best survival, followed by those greater than 1.86 and lowest in those below 1.67 (P = 0.0016). For patients with baseline Kt/V below 1.80, those with subsequent Kt/V above 1.76 had better survival than those below (P = 0.033). Conclusion. Our data suggested that a negative effect of peritoneal Kt/V on survival is apparent at a level below 1.67 and there exists a limit of its effect at around 1.80. We suggested a minimal Kt/V target of 1.70 and an optimal target at 1.80 in anuric patients based on survival data. Prospective randomized study is required to confirm this finding. © 2005 by the International Society of Nephrology.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationKidney International, 2005, v. 67 n. 5, p. 2032-2038 [How to Cite?]
DOI: http://dx.doi.org/10.1111/j.1523-1755.2005.00305.x
 
dc.identifier.citeulike157241
 
dc.identifier.doihttp://dx.doi.org/10.1111/j.1523-1755.2005.00305.x
 
dc.identifier.epage2038
 
dc.identifier.hkuros99030
 
dc.identifier.isiWOS:000228582900051
 
dc.identifier.issn0085-2538
2012 Impact Factor: 7.916
2012 SCImago Journal Rankings: 2.697
 
dc.identifier.issue5
 
dc.identifier.openurl
 
dc.identifier.pmid15840054
 
dc.identifier.scopuseid_2-s2.0-17744367027
 
dc.identifier.spage2032
 
dc.identifier.urihttp://hdl.handle.net/10722/78601
 
dc.identifier.volume67
 
dc.languageeng
 
dc.publisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ki/index.html
 
dc.publisher.placeUnited Kingdom
 
dc.relation.ispartofKidney International
 
dc.relation.referencesReferences in Scopus
 
dc.subject.meshAdult
 
dc.subject.meshAged
 
dc.subject.meshAged, 80 and over
 
dc.subject.meshAnuria - mortality - physiopathology - therapy
 
dc.subject.meshBiological Transport, Active
 
dc.subject.meshFemale
 
dc.subject.meshHong Kong - epidemiology
 
dc.subject.meshHumans
 
dc.subject.meshKidney - physiopathology
 
dc.subject.meshKinetics
 
dc.subject.meshMale
 
dc.subject.meshMiddle Aged
 
dc.subject.meshPeritoneal Dialysis - mortality
 
dc.subject.meshPeritoneum - physiopathology
 
dc.subject.meshRetrospective Studies
 
dc.subject.meshSurvival Analysis
 
dc.subjectKt/V
 
dc.subjectMinimal
 
dc.subjectOptimal
 
dc.subjectPeritoneal dialysis
 
dc.subjectSurvival
 
dc.subjectTarget
 
dc.titleMinimal and optimal peritoneal Kt/V targets: Results of an anuric peritoneal dialysis patient's survival analysis
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong
  2. Tung Wah Hospital