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Article: Important differentiation of factors that predict outcome in peritoneal dialysis patients with different degrees of residual renal function

TitleImportant differentiation of factors that predict outcome in peritoneal dialysis patients with different degrees of residual renal function
Authors
KeywordsCardiovascular
Inflammation
Malnutrition
Mortality
Peritoneal dialysis
Issue Date2005
PublisherOxford University Press. The Journal's web site is located at http://ndt.oxfordjournals.org/
Citation
Nephrology Dialysis Transplantation, 2005, v. 20 n. 2, p. 396-403 How to Cite?
AbstractBackground. Residual renal function (RRF) is an important predictor of outcome in peritoneal dialysis (PD) patients. Whether results from survival studies in dialysis patients with RRF can also be extrapolated to anuric patients remains uncertain. In this observational study, we examined the characteristics of PD patients with a residual glomerular filtration rate (GFR) ≥1 ml/min per 1.73 m2 vs those with complete anuria and differentiated factors that predict outcome in the two groups of patients. Methods. Two hundred and forty-six continuous ambulatory peritoneal dialysis (CAPD) patients (39% being completely anuric) were recruited from a single regional dialysis centre. Assessments of haemodynamic, echocardiographic, nutritional and biochemical parameters and indices of dialysis adequacy were done at study baseline and were related to outcomes. Results. During the prospective follow-up of 30.8 ± 13.8 (mean ± SD) months, 28.0% of patients with residual GFR ≥1 ml/min per 1.73 m2 vs 50.5% of anuric patients had died (P=0.005). The overall 2 year patient survival was 89.7 and 65.0% for patients with GFR ≥1 ml/min per 1.73 m2 and anuric patients, respectively (P=0.0012). Compared with patients with GFR ≥1 ml/min per 1.73 m2, anuric patients were dialysed for longer (P<0.001), were more anaemic (P<0.005), and had higher calcium-phosphorus product (P<0.01), higher C-reactive protein (P<0.001), lower serum albumin (P<0.05), greater prevalence of malnutrition according to subjective global assess ment (P<0.05) and more severe cardiac hypertrophy (P<0.001) at baseline. Using multivariable Cox regression analysis, serum albumin, left ventricular mass index and residual GFR were significant factors associated with mortality in patients with GFR ≥1 ml/min per 1.73 m2, while increasing age, atherosclerotic vascular disease and higher C-reactive protein were associated with greater mortality in anuric PD patients. Conclusions. Our study demonstrates more adverse cardiovascular, inflammatory, nutritional and metabolic profiles as well as higher mortality in anuric PD patients. Furthermore, factors associated with mortality are also not equivalent for PD patients with and without RRF, suggesting that patients with and without RRF are qualitatively different. © ERA-EDTA 2004; all rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/162790
ISSN
2023 Impact Factor: 4.8
2023 SCImago Journal Rankings: 1.414
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWang, AYMen_US
dc.contributor.authorWoo, Jen_US
dc.contributor.authorWang, Men_US
dc.contributor.authorSea, MMMen_US
dc.contributor.authorSanderson, JEen_US
dc.contributor.authorLui, SFen_US
dc.contributor.authorLi, PKTen_US
dc.date.accessioned2012-09-05T05:23:33Z-
dc.date.available2012-09-05T05:23:33Z-
dc.date.issued2005en_US
dc.identifier.citationNephrology Dialysis Transplantation, 2005, v. 20 n. 2, p. 396-403en_US
dc.identifier.issn0931-0509en_US
dc.identifier.urihttp://hdl.handle.net/10722/162790-
dc.description.abstractBackground. Residual renal function (RRF) is an important predictor of outcome in peritoneal dialysis (PD) patients. Whether results from survival studies in dialysis patients with RRF can also be extrapolated to anuric patients remains uncertain. In this observational study, we examined the characteristics of PD patients with a residual glomerular filtration rate (GFR) ≥1 ml/min per 1.73 m2 vs those with complete anuria and differentiated factors that predict outcome in the two groups of patients. Methods. Two hundred and forty-six continuous ambulatory peritoneal dialysis (CAPD) patients (39% being completely anuric) were recruited from a single regional dialysis centre. Assessments of haemodynamic, echocardiographic, nutritional and biochemical parameters and indices of dialysis adequacy were done at study baseline and were related to outcomes. Results. During the prospective follow-up of 30.8 ± 13.8 (mean ± SD) months, 28.0% of patients with residual GFR ≥1 ml/min per 1.73 m2 vs 50.5% of anuric patients had died (P=0.005). The overall 2 year patient survival was 89.7 and 65.0% for patients with GFR ≥1 ml/min per 1.73 m2 and anuric patients, respectively (P=0.0012). Compared with patients with GFR ≥1 ml/min per 1.73 m2, anuric patients were dialysed for longer (P<0.001), were more anaemic (P<0.005), and had higher calcium-phosphorus product (P<0.01), higher C-reactive protein (P<0.001), lower serum albumin (P<0.05), greater prevalence of malnutrition according to subjective global assess ment (P<0.05) and more severe cardiac hypertrophy (P<0.001) at baseline. Using multivariable Cox regression analysis, serum albumin, left ventricular mass index and residual GFR were significant factors associated with mortality in patients with GFR ≥1 ml/min per 1.73 m2, while increasing age, atherosclerotic vascular disease and higher C-reactive protein were associated with greater mortality in anuric PD patients. Conclusions. Our study demonstrates more adverse cardiovascular, inflammatory, nutritional and metabolic profiles as well as higher mortality in anuric PD patients. Furthermore, factors associated with mortality are also not equivalent for PD patients with and without RRF, suggesting that patients with and without RRF are qualitatively different. © ERA-EDTA 2004; all rights reserved.en_US
dc.languageengen_US
dc.publisherOxford University Press. The Journal's web site is located at http://ndt.oxfordjournals.org/en_US
dc.relation.ispartofNephrology Dialysis Transplantationen_US
dc.subjectCardiovascular-
dc.subjectInflammation-
dc.subjectMalnutrition-
dc.subjectMortality-
dc.subjectPeritoneal dialysis-
dc.subject.meshCohort Studiesen_US
dc.subject.meshFemaleen_US
dc.subject.meshGlomerular Filtration Rateen_US
dc.subject.meshHumansen_US
dc.subject.meshKidney Failure, Chronic - Physiopathology - Therapyen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshNutrition Assessmenten_US
dc.subject.meshPeritoneal Dialysis, Continuous Ambulatory - Methodsen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleImportant differentiation of factors that predict outcome in peritoneal dialysis patients with different degrees of residual renal functionen_US
dc.typeArticleen_US
dc.identifier.emailWang, M:meiwang@hkucc.hku.hken_US
dc.identifier.authorityWang, M=rp00281en_US
dc.description.naturelink_to_OA_fulltexten_US
dc.identifier.doi10.1093/ndt/gfh331en_US
dc.identifier.pmid15187196-
dc.identifier.scopuseid_2-s2.0-14044267442en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-14044267442&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume20en_US
dc.identifier.issue2en_US
dc.identifier.spage396en_US
dc.identifier.epage403en_US
dc.identifier.isiWOS:000226997600022-
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridWang, AYM=13606226000en_US
dc.identifier.scopusauthoridWoo, J=36040369400en_US
dc.identifier.scopusauthoridWang, M=7406690398en_US
dc.identifier.scopusauthoridSea, MMM=6602566931en_US
dc.identifier.scopusauthoridSanderson, JE=7202371250en_US
dc.identifier.scopusauthoridLui, SF=7102379144en_US
dc.identifier.scopusauthoridLi, PKT=25928016800en_US
dc.identifier.citeulike88513-
dc.identifier.issnl0931-0509-

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