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Article: Independent effects of residual renal function and dialysis adequacy on nutritional status and patient outcome in continuous ambulatory peritoneal dialysis

TitleIndependent effects of residual renal function and dialysis adequacy on nutritional status and patient outcome in continuous ambulatory peritoneal dialysis
Authors
KeywordsDialysis adequacy
Nutrition
Peritoneal dialysis
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. 6, p. 1056-1064 How to Cite?
AbstractDialysis adequacy has a major impact on outcome of continuous ambulatory peritoneal dialysis (CAPD) patients. However, there is a substantial confounding effect by residual renal function in most studies. We differentiated the effects of dialysis adequacy from those of residual renal function on nutritional status and outcome of CAPD patients. We identified 168 CAPD patients treated in our center between September 1995 and December 1996 and categorized them into three groups: 49 patients with an average total Kt/V of 1.93 ± 0.18 and a median residual glomerular filtration rate (GFR) of 0.07 mL/min/1.73m2 in the dialysis-dependent (DD) group; 48 patients with an average total Kt/V of 2.03 ± 0.25 and a residual GFR of 2.33 mL/min/1.73m2 in the residual renal function (RRF) group; and 71 patients with an average total Kt/V of 1.38 ± 0.22 and a residual GFR of 0.05 mL/min/1.73m2 in the control (CTL) group. They were followed-up for 1 year to compare baseline nutritional status and 1-year morbidity. Baseline normalized protein catabolic rates (NPCR) are 1.00 ± 0.20 and 0.96 ± 0.19 (for RRF and DD, respectively) versus 0.89 ± 0.16 g/kg/d for CTL (P < 0.01). Percentage lean body mass (%LBM) was 71.6 ± 9.8 and 71.5 ± 10.0 (for RRF and DD, respectively) versus 65.2 ± 8.5% for CTL (P < 0.001). No difference was seen in the nutritional status between RRF and DD groups. Duration of hospitalization for 1 year was 6.9 ± 11.8 days in the RRF group versus 14.9 ± 25.1 in the DD and 10.6 ± 11.6 days in the CTL groups (P < 0.05). The peritonitis rate was 44.4 patient-months for the RRF group, versus 13.6 for the DD and 12.9 for the CTL groups (P < 0.05). There also was a trend toward superior 1-year technique survival in the RRF group, but the number of observations was small. There was no difference in duration of hospitalization, peritonitis rate, and technique survival between the DD and CTL groups. Short-term morbidity in patients without residual renal function appears to be independent of total Kt/V, although Kt/V may have some effects on nutritional status. The assumption that renal and peritoneal clearances are equivalent must be carefully reexamined. Further studies on the effect of dialysis adequacy in patients without residual renal function are urgently needed.
Persistent Identifierhttp://hdl.handle.net/10722/78787
ISSN
2014 Impact Factor: 5.900
2014 SCImago Journal Rankings: 1.651
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorSzeto, CCen_HK
dc.contributor.authorLai, KNen_HK
dc.contributor.authorWong, TYHen_HK
dc.contributor.authorLaw, MCen_HK
dc.contributor.authorLeung, CBen_HK
dc.contributor.authorYu, AWYen_HK
dc.contributor.authorLi, PKTen_HK
dc.date.accessioned2010-09-06T07:46:43Z-
dc.date.available2010-09-06T07:46:43Z-
dc.date.issued1999en_HK
dc.identifier.citationAmerican Journal Of Kidney Diseases, 1999, v. 34 n. 6, p. 1056-1064en_HK
dc.identifier.issn0272-6386en_HK
dc.identifier.urihttp://hdl.handle.net/10722/78787-
dc.description.abstractDialysis adequacy has a major impact on outcome of continuous ambulatory peritoneal dialysis (CAPD) patients. However, there is a substantial confounding effect by residual renal function in most studies. We differentiated the effects of dialysis adequacy from those of residual renal function on nutritional status and outcome of CAPD patients. We identified 168 CAPD patients treated in our center between September 1995 and December 1996 and categorized them into three groups: 49 patients with an average total Kt/V of 1.93 ± 0.18 and a median residual glomerular filtration rate (GFR) of 0.07 mL/min/1.73m2 in the dialysis-dependent (DD) group; 48 patients with an average total Kt/V of 2.03 ± 0.25 and a residual GFR of 2.33 mL/min/1.73m2 in the residual renal function (RRF) group; and 71 patients with an average total Kt/V of 1.38 ± 0.22 and a residual GFR of 0.05 mL/min/1.73m2 in the control (CTL) group. They were followed-up for 1 year to compare baseline nutritional status and 1-year morbidity. Baseline normalized protein catabolic rates (NPCR) are 1.00 ± 0.20 and 0.96 ± 0.19 (for RRF and DD, respectively) versus 0.89 ± 0.16 g/kg/d for CTL (P < 0.01). Percentage lean body mass (%LBM) was 71.6 ± 9.8 and 71.5 ± 10.0 (for RRF and DD, respectively) versus 65.2 ± 8.5% for CTL (P < 0.001). No difference was seen in the nutritional status between RRF and DD groups. Duration of hospitalization for 1 year was 6.9 ± 11.8 days in the RRF group versus 14.9 ± 25.1 in the DD and 10.6 ± 11.6 days in the CTL groups (P < 0.05). The peritonitis rate was 44.4 patient-months for the RRF group, versus 13.6 for the DD and 12.9 for the CTL groups (P < 0.05). There also was a trend toward superior 1-year technique survival in the RRF group, but the number of observations was small. There was no difference in duration of hospitalization, peritonitis rate, and technique survival between the DD and CTL groups. Short-term morbidity in patients without residual renal function appears to be independent of total Kt/V, although Kt/V may have some effects on nutritional status. The assumption that renal and peritoneal clearances are equivalent must be carefully reexamined. Further studies on the effect of dialysis adequacy in patients without residual renal function are urgently needed.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.subjectDialysis adequacyen_HK
dc.subjectNutritionen_HK
dc.subjectPeritoneal dialysisen_HK
dc.titleIndependent effects of residual renal function and dialysis adequacy on nutritional status and patient outcome 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=6&spage=1056&epage=1064&date=1999&atitle=Independent+effects+of+residual+renal+function+and+dialysis+adequacy+on+nutritional+status+and+patient+outcome+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.pmid10585315en_HK
dc.identifier.scopuseid_2-s2.0-0032740125en_HK
dc.identifier.hkuros50635en_HK
dc.identifier.volume34en_HK
dc.identifier.issue6en_HK
dc.identifier.spage1056en_HK
dc.identifier.epage1064en_HK
dc.identifier.isiWOS:000084126000011-
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.scopusauthoridLeung, CB=16750769500en_HK
dc.identifier.scopusauthoridYu, AWY=7401478900en_HK
dc.identifier.scopusauthoridLi, PKT=25928016800en_HK

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