Kidney and Blood Pressure Research

Original Paper

Free Access

Definition and Risk Factors of Rapidly Declining Residual Renal Function in Peritoneal Dialysis: An Observational Study

Herget-Rosenthal S.a, b · von Ostrowski M.a · Kribben A.a

Author affiliations

aDepartment of Nephrology, University Hospital, University Duisburg-Essen, Essen, and bDepartment of Medicine, Rotes Kreuz Krankenhaus, Bremen, Germany

Corresponding Author

Stefan Herget-Rosenthal, MD, FASN

Department of Medicine, Rotes Kreuz Krankenhaus

St. Pauli Deich 24, DE–28199 Bremen (Germany)

Tel. +49 421 559 9301

E-Mail herget-rosenthal.s@roteskreuzkrankenhaus.de

Keywords: Peritoneal dialysisResidual renal functionRisk factorsUrine outputEnd-stage renal diseaseGlomerular filtration rate

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Abstract

Background: It is critical to preserve residual renal function (RRF) in peritoneal dialysis (PD), as RRF is associated with lower morbidity and mortality. There is no uniform definition of RRF, and rapidly declining RRF has rarely been studied and predominately limited to single factor analysis and not corrected for lead-time bias. Methods: An observational study in 71 incident PD patients. RRF was defined as urine output (UO) ≥500 ml/day and renal glomerular filtration rate (rGFR) ≥2 ml/min/1.73 m2, rapid declining RRF as UO <500 ml/day and rGFR <2 ml/min/1.73 m2 occurring within 6 months which were separately evaluated. Independent risk factors associated with rapid RRF decline were identified while correcting for lead-time bias. Results: RRF declined rapidly by both definitions in 65% patients 2.5 years after PD start. Both definitions of RRF decline were consistent in 96%. Nephrotoxic drugs, renal transplant failure and absent angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB) were independent risk factors associated with rapidly declining RRF defined both by definitions, intravascular radiocontrast additionally for UO decline. Conclusions: Most PD patients demonstrated rapid RRF decline, independent of its definition. Both definitions are highly consistent and interchangeable. Nephrotoxic drugs and radiocontrast were identified as risk factors of acute, absent ACEI or ARB, and renal transplant failure of chronic renal injury.

© 2012 S. Karger AG, Basel



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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: February 07, 2011
Accepted: September 05, 2011
Published online: January 03, 2012
Issue release date: May 2012

Number of Print Pages: 9
Number of Figures: 2
Number of Tables: 4

ISSN: 1420-4096 (Print)
eISSN: 1423-0143 (Online)

For additional information: https://www.karger.com/KBR

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2012, Vol.35, No. 4

May 2012

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