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Article: Minimal and optimal peritoneal Kt/V targets: Results of an anuric peritoneal dialysis patient's survival analysis

TitleMinimal and optimal peritoneal Kt/V targets: Results of an anuric peritoneal dialysis patient's survival analysis
Authors
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
Citation
Kidney International, 2005, v. 67 n. 5, p. 2032-2038 How to Cite?
Abstract
Background. 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.
Persistent Identifierhttp://hdl.handle.net/10722/78601
ISSN
2013 Impact Factor: 8.520
ISI Accession Number ID
References

 

Author Affiliations
  1. The University of Hong Kong
  2. Tung Wah Hospital
DC FieldValueLanguage
dc.contributor.authorLo, WKen_HK
dc.contributor.authorLui, SLen_HK
dc.contributor.authorChan, TMen_HK
dc.contributor.authorLi, FKen_HK
dc.contributor.authorLam, MFen_HK
dc.contributor.authorTse, KCen_HK
dc.contributor.authorTang, SCWen_HK
dc.contributor.authorChoy, CBYen_HK
dc.contributor.authorLai, KNen_HK
dc.date.accessioned2010-09-06T07:44:41Z-
dc.date.available2010-09-06T07:44:41Z-
dc.date.issued2005en_HK
dc.identifier.citationKidney International, 2005, v. 67 n. 5, p. 2032-2038en_HK
dc.identifier.issn0085-2538en_HK
dc.identifier.urihttp://hdl.handle.net/10722/78601-
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.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.subjectKt/Ven_HK
dc.subjectMinimalen_HK
dc.subjectOptimalen_HK
dc.subjectPeritoneal dialysisen_HK
dc.subjectSurvivalen_HK
dc.subjectTargeten_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshAged, 80 and overen_HK
dc.subject.meshAnuria - mortality - physiopathology - therapyen_HK
dc.subject.meshBiological Transport, Activeen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHong Kong - epidemiologyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshKidney - physiopathologyen_HK
dc.subject.meshKineticsen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshPeritoneal Dialysis - mortalityen_HK
dc.subject.meshPeritoneum - physiopathologyen_HK
dc.subject.meshRetrospective Studiesen_HK
dc.subject.meshSurvival Analysisen_HK
dc.titleMinimal and optimal peritoneal Kt/V targets: Results of an anuric peritoneal dialysis patient's survival analysisen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0085-2538&volume=67&issue=5&spage=2032&epage=2038&date=2005&atitle=Minimal+and+optimal+peritoneal+Kt/V+targets:+results+of+an+anuric+peritoneal+dialysis+patient%27s+survival+analysis.en_HK
dc.identifier.emailChan, TM: dtmchan@hku.hken_HK
dc.identifier.emailTang, SCW: scwtang@hku.hken_HK
dc.identifier.emailLai, KN: knlai@hku.hken_HK
dc.identifier.authorityChan, TM=rp00394en_HK
dc.identifier.authorityTang, SCW=rp00480en_HK
dc.identifier.authorityLai, KN=rp00324en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/j.1523-1755.2005.00305.xen_HK
dc.identifier.pmid15840054en_HK
dc.identifier.scopuseid_2-s2.0-17744367027en_HK
dc.identifier.hkuros99030en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-17744367027&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume67en_HK
dc.identifier.issue5en_HK
dc.identifier.spage2032en_HK
dc.identifier.epage2038en_HK
dc.identifier.isiWOS:000228582900051-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridLo, WK=7201502414en_HK
dc.identifier.scopusauthoridLui, SL=7102379130en_HK
dc.identifier.scopusauthoridChan, TM=7402687700en_HK
dc.identifier.scopusauthoridLi, FK=8219093900en_HK
dc.identifier.scopusauthoridLam, MF=35300050600en_HK
dc.identifier.scopusauthoridTse, KC=7102609864en_HK
dc.identifier.scopusauthoridTang, SCW=7403437082en_HK
dc.identifier.scopusauthoridChoy, CBY=9735613000en_HK
dc.identifier.scopusauthoridLai, KN=7402135706en_HK
dc.identifier.citeulike157241-

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