Nephron

Original Paper

Importance of Residual Renal Function in Continuous Ambulatory Peritoneal Dialysis: Its Influence on Different Parameters of Renal Replacement Treatment

López-Menchero R.a · Miguel A.a · García-Ramón R.a · Pérez-Contreras J.b · Girbés V.c

Author affiliations

aDepartment of Nephrology, Clinical Hospital, University of Valencia, bDepartment of Nephrology, General Hospital, University of Alicante, and cStatistics Department, University of Valencia, Spain

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Nephron 1999;83:219–225

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: October 13, 1999
Issue release date: November 1999

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 4

ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)

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

Abstract

Objective: To study the influence of residual renal function (RRF) on different parameters of the renal substitutive treatment offered by peritoneal dialysis. Methods: We analyzed the impact of RRF on dialysis dose, nutrition parameters, anemia and phosphocalcic metabolism in 37 patients with end-stage renal disease (ESRD) treated by continuous ambulatory peritoneal dialysis (CAPD). Analytical controls were done every 6 months after an initial assessment at the end of the first month of treatment. Multiple lineal regression models were used as the statistical method to analyze the influence of RRF on different theoretically dependent factors. RRF was calculated as a mean of creatinine and urea clearances. Three observations per patient were used: one at the end of the first month of treatment; a final one at the end of follow-up (mean time 24.2 ± 11.4 months), and at a mean time between them (13.4 ± 6.7 months), with a final number of 111 observations. Results: Dialysis dose: RRF was the most important factor in terms of creatinine clearance (r2 = 0.94; β = 0.999), KT/V (r2 = 0.68; β = 0.819) and β2-microglobulin levels (r2 = 0.46; β = –0.489). Nutrition parameters: RRF was a determinant factor for normalized protein catabolic rate (r2 = 0.53; β = 0.471), percent lean body mass (r2 = 0.45; β = 0.446) and albumin levels (r2 = 0.25; β = 0.229). Anemia: RRF was the most important factor when studying hemoglobin levels (r2 = 0.28; β = 0.407). Phosphocalcic metabolism: Between the analyzed factors, RRF was the only one which reached significance on serum phosphate levels (r2 = 0.19; β = –0.594). RRF did not show any relationship with either calcium or PTH levels. Conclusions: Independent of other factors, RRF in CAPD is positively and directly related to dialysis dose, β2-microglobulin levels, nutrition parameters (albumin, normalized protein catabolic rate and percent lean body mass, hemoglobin and serum phosphate levels.




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References

  1. National Kidney Foundation-Dialysis Outcomes Quality Initiative: Clinical practice guidelines for peritoneal dialysis adequacy: Adequate dose of peritoneal dialysis. Am J Kidney Dis 1997;30(suppl):86–92.
  2. Blake P, Burkhart JM, Churchill DN, et al: Recommended clinical practices for maximizing peritoneal dialysis clearances. Perit Dial Int 1996;16:448–456.
  3. Churchill DN, Taylor DW, Keshaviah PR (Canada-USA study group): Adequacy of dialysis and nutrition in continuous peritoneal dialysis: Association with clinical outcomes. J Am Soc Nephrol 1996;7:198–207.
  4. Harty J, Boulton H, Heelis N, Uttley L, Venning M, Gokal R: Limitations of kinetic model as predictor of nutritional and dialysis adequacy in continuous ambulatory peritoneal dialysis patients. Am J Nephrol 1993;13:454–463.
  5. Tattersall JE, Doyle S, Greenwood N, Farrington K: Kinetic modelling and underdialysis in CAPD patients. Nephrol Dial Transplant 1993;8:535–538.
  6. Blake PG: A critique of the Canada-USA (CANUSA) peritoneal dialysis study. Perit Dial Int 1996;16:243–245.
  7. Lysaght MJ, Vonesh EF, Gotch F, et al: The influence of dialysis treatment modality on the decline of remaining renal function. ASAIO Trans 1991;37:598–604.
  8. Lameire NH: The impact of residual renal function on the adequacy of peritoneal dialysis. Nephron 1997;77:13–28.
  9. Blake PG, Sombolos K, Abraham G, Weissgarten J, Pemberton R, Lian Chu G, Oreopoulos DG: Lack of correlation between urea kinetic indices and clinical outcomes in CAPD patients. Kidney Int 1991;39:700–706.
  10. Rottembourg J, Allouache M, Musset L, Jacobs C: Beta2-microglobulin kinetics in dialysed patients: Haemodialysis vs. continuous ambulatory peritoneal dialysis (abstract). Nephrol Dial Transplant 1987;2:248.
    External Resources
  11. Mistry CD, O’Donohue DJ, Nelson S, Gokal R, Ballardie FW: Kinetic and clinical studies of β2-microglobulin in continuous ambulatory peritoneal dialysis: Influence of renal and enhanced peritoneal clearances using glucose polymer. Nephrol/Dial Transplant 1990;5:513–519.
  12. Tielemans C, Dratwa M, Begmann P, Goldman M, Flamion B, Collart F: Continuous ambulatory peritoneal dialysis vs. haemodialysis: A lesser risk of amyloidosis? Nephrol Dial Transplant 1988;3:291–294.
    External Resources
  13. Scalamogna A, Imbasciati E, De Vecchi A, Castelnovo C, Pagliari B, De Cristofaro V, Ponticelli C: Beta-2-microglobulin in patients on peritoneal dialysis and hemodialysis. Perit Dial Int 1989;9:37–40.
    External Resources
  14. Young GA, Kopple JD, Lindholm B, et al: Nutritional assessment of continuous ambulatory peritoneal dialysis patients: An international study. Am J Kidney Dis 1991;17:462–471.
  15. Schreiber MJ: Nutrition and dialysis adequacy. Perit Dial Int 1995;15(suppl):39–49.
  16. Jones MR: Etiology of severe malnutrition: Results of an international cross sectional study in continuous ambulatory peritoneal dialysis patients. Am J Kidney Dis 1994;23:412–420.
  17. Pollock CA, Ibels LS, Allen BJ: Nutritional markers and survival in maintenance dialysis patients. Nephron 1996;74:625–641.
  18. Brandes JC, Piering WF, Beres JA, Blumenthal SS, Fritsche C: Clinical outcome of continuous ambulatory peritoneal dialysis predicted by urea and creatinine kinetics. J Am Soc Nephrol 1992;2:1430–1435.
  19. Lindsay RM, Spanner E, Heidenheim P, Lefèvre JM, Hodsman A, Baird J, Allison MEM: Which comes first, Kt/V or PCR. Chicken or egg? Kidney Int 1992;42(suppl):32–36.
  20. Nolph KD, Moore HL, Prowant B, Meyer M, Twardowsky ZJ, Khanna R, Ponferrada L, Keshaviah P: Cross sectional assessment of weekly urea and creatinine clearances and indices of nutrition in continuous ambulatory peritoneal dialysis patients. Perit Dial Int 1993;13:178–183.
  21. Roxe DM, del Greco F, Hughes J, et al: Hemodialysis vs. peritoneal dialysis: Results of a 3-year prospective controlled study. Kidney Int 1981;19:341–348.
    External Resources
  22. Chandra M, Clermons GK, McVicar M, Wilkes B, Bluestone PA, Mailloux LU, Mossey RT: Serum erythropoietin levels and hematocrit in end-stage renal disease: Influence of the mode of dialysis. Am J Kidney Dis 1988;12:208–213.
    External Resources
  23. Maiorca R, Cancarini GC, Camerini C, Brunori G, Manili L, Movilli E, Feller P, Mombelloni S: Is CAPD competitive with hemodialysis for long term treatment of uremic patients? Nephrol Dial Transplant 1989;4:244–253.
    External Resources
  24. Howard AD, Moore J, Welch PG, Gouge SF: Analysis of the quantitative relationship between anemia and chronic renal failure. Am J Med Sci 1989;297:309–313.
    External Resources
  25. Nolph KD, Prowant BF, Moore HL, Reyad SE: Hematocrit and residual renal creatinine clearance in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Perit Dial Int 1990;10:279–282.
  26. Blake PG, Balaskas EV, Izatt S, Oreopoulos DG: Is total creatinine clearance a good predictor of clinical outcomes in continuous ambulatory peritoneal dialysis? Perit Dial Int 1992;12:353–358.
  27. Opatrná S, Opatrný K Jr, Cejková P, Šefrna F, Hostašová A, Opatrný K: Relationship between anemia and adequacy of continuous ambulatory peritoneal dialysis. Nephron 1997;77:359–360.
  28. Korbet SM: Anemia and erythropoietin in hemodialysis and continuous ambulatory peritoneal dialysis. Kidney Int 1993;43(suppl):111–119.
  29. Blummenkrantz MJ, Kopple JD, Moran JK, Coburn JW: Metabolic balance studies and dietary protein requirements in patients undergoing continuous ambulatory peritoneal dialysis. Kidney Int 1982;21:849–861.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: October 13, 1999
Issue release date: November 1999

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 4

ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)

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


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