Nephrol Dial Transplant (2001) 16: 2240-2245
© 2001 European Renal Association-European Dialysis and Transplant Association
Preliminary Reports
Association between inflammation and changes in residual renal function and peritoneal transport rate during the first year of dialysis
1 Divisions of Baxter Novum and Renal Medicine, Department of Clinical Science, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden and 2 Hyonam Kidney Laboratory, Soon Chun Hyang University, Seoul, Korea Republic
Background. Peritoneal transport rate, a major determinant of peritoneal dialysis (PD) patient survival, increases in most patients starting on PD, while in other patients peritoneal transport rate may decline. Although several factors may contribute to changes in peritoneal transport rate, inflammation is known to be associated with a high peritoneal transport rate, and residual renal function (RRF), which often declines after start of PD, may also be related to inflammation. Therefore, we hypothesized that changes in peritoneal transport rate during patients’ first year on PD and declining RRF may be linked with inflammation.
Methods. A total of 76 PD patients (40 males, mean age 56.8±14.1 years), who underwent two peritoneal equilibration tests at a mean of 0.4 months and 1 year after beginning PD, were included in the study. Based on the change in dialysate to plasma creatinine concentration ratio at 4-h dwell (D/P Cr) during first year on PD, the patients were divided into decreased or unchanged (group DUC; n=22) and increased (group I; n=54) groups.
Results. Initially, group I had a lower proportion of high transporters and more often high serum C-reactive protein (sCRP, 
10 mg/l) and lower RRF compared with the DUC group. In group I, serum albumin and RRF decreased significantly and dialysate protein loss and glucose absorption increased significantly during the first year on PD. When patients were divided into two groups based on median change in RRF (1.9 ml/min), patients with a decrease in RRF >1.9 ml/min during first year on PD had a higher proportion of high sCRP, higher D/P Cr, and higher changes in D/P Cr compared to patients with a decrease in RRF 
1.9 ml/min. Patients with elevated sCRP at one year included a higher proportion of patients who had high sCRP at the start of PD, higher increase in D/P Cr, lower serum albumin, lower RRF, and more decrease in RRF during first year on PD compared with patients having normal sCRP. RRF was inversely correlated with changes in D/P Cr during the first year on PD (r=-0.28, P=0.02). Multiple regression analysis revealed that the only factors affecting changes in D/P Cr were high sCRP and a low RRF.
Conclusions. Our preliminary short-term study suggests that changes in peritoneal transport rate during patients’ first year on PD may be linked with inflammation and declining residual renal function. Inflammation and residual renal function were identified as the only independent factors determining peritoneal transport rate during the first year on PD. It is possible that inflammation may cause both an increase in peritoneal transport rate and a decline in residual renal function, or that the decline in residual renal function and the increase in peritoneal transport rate may induce or aggravate inflammation. Further studies are needed to confirm these findings.
Keywords: dialysate glucose amount; inflammation; peritoneal transport rate; residual renal function; serum albumin; serum CRP
Deceased. Correspondence and offprint requests to: Bengt Lindholm, MD, PhD, Divisions of Baxter Novum and Renal Medicine, K 56 Huddinge University Hospital, SE-141 86 Huddinge, Sweden. Email: bengt.lindholm{at}klinvet.ki.se
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A. Y.-M. Wang, C. W.-K. Lam, M. Wang, I. H.-S. Chan, S.-F. Lui, and J. E. Sanderson Is Valvular Calcification a Part of the Missing Link between Residual Kidney Function and Cardiac Hypertrophy in Peritoneal Dialysis Patients? Clin. J. Am. Soc. Nephrol., October 1, 2009; 4(10): 1629 - 1636. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y.-F. Lin, V.-C. Wu, W.-J. Ko, Y.-S. Chen, Y.-M. Chen, W.-Y. Li, N.-K. Chou, A. Chao, T.-M. Huang, F.-C. Chang, et al. Residual Urine Output and Postoperative Mortality in Maintenance Hemodialysis Patients Am. J. Crit. Care., September 1, 2009; 18(5): 446 - 455. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Perl and J. M. Bargman PREDIALYSIS INTERVENTIONS FOR POSTDIALYSIS OUTCOMES Perit. Dial. Int., May 1, 2009; 29(3): 270 - 273. [Full Text] [PDF]
|
|
|
|
|
|
Y.-H. Hwang, M.-J. Son, J. Yang, K. Kim, W. Chung, K.-W. Joo, Y. Kim, C. Ahn, and K.-H. Oh EFFECTS OF INTERLEUKIN-6 T15A SINGLE NUCLEOTIDE POLYMORPHISM ON BASELINE PERITONEAL SOLUTE TRANSPORT RATE IN INCIDENT PERITONEAL DIALYSIS PATIENTS Perit. Dial. Int., January 1, 2009; 29(1): 81 - 88. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K.-H. Oh, J.-Y. Moon, J. Oh, S. G. Kim, Y.-H. Hwang, S. Kim, J. S. Lee, and C. Ahn Baseline peritoneal solute transport rate is not associated with markers of systemic inflammation or comorbidity in incident Korean peritoneal dialysis patients Nephrol. Dial. Transplant., July 1, 2008; 23(7): 2356 - 2364. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Canaud Residual renal function: the delicate balance betweenbenefits and risks Nephrol. Dial. Transplant., June 1, 2008; 23(6): 1801 - 1805. [Full Text] [PDF]
|
|
|
|
|
|
E. Garcia-Lopez, J. J. Carrero, M. E. Suliman, B. Lindholm, and P. Stenvinkel RISK FACTORS FOR CARDIOVASCULAR DISEASE IN PATIENTS UNDERGOING PERITONEAL DIALYSIS Perit. Dial. Int., June 1, 2007; 27(Supplement_2): S205 - S209. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.-J. F. Reyes, M.-A. Bajo, C. Hevia, G. del Peso, S. Ros, A. G. de Miguel, A. Cirugeda, M.-J. Castro, J. A. Sanchez-Tomero, and R. Selgas Inherent high peritoneal transport and ultrafiltration deficiency: their mid-term clinical relevance Nephrol. Dial. Transplant., January 1, 2007; 22(1): 218 - 223. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Breborowicz, K. Pawlaczyk, A. Polubinska, K. Gorna, A. Wieslander, O. Carlsson, P. Tam, and G. Wu Effect of peritoneal dialysis on renal morphology and function Nephrol. Dial. Transplant., December 1, 2006; 21(12): 3539 - 3544. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. G. Heaf, S. Sarac, and S. Afzal A high peritoneal large pore fluid flux causes hypoalbuminaemia and is a risk factor for death in peritoneal dialysis patients Nephrol. Dial. Transplant., October 1, 2005; 20(10): 2194 - 2201. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. del Peso, M. J. Fernandez-Reyes, C. Hevia, M. A. Bajo, M. J. Castro, A. Cirugeda, J. A. Sanchez-Tomero, and R. Selgas Factors influencing peritoneal transport parameters during the first year on peritoneal dialysis: peritonitis is the main factor Nephrol. Dial. Transplant., June 1, 2005; 20(6): 1201 - 1206. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Hocher, R. Ziebig, C. Altermann, R. Krause, G. Asmus, C.-M. Richter, T. Slowinski, P. Sinha, and H.-H. Neumayer Different Impact of Biomarkers as Mortality Predictors among Diabetic and Nondiabetic Patients Undergoing Hemodialysis J. Am. Soc. Nephrol., September 1, 2003; 14(9): 2329 - 2337. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Y.-M. Wang, J. Woo, C. W.-K. Lam, M. Wang, M. M.-M. Sea, S.-F. Lui, P. K.-T. Li, and J. Sanderson Is a Single Time Point C-Reactive Protein Predictive of Outcome in Peritoneal Dialysis Patients? J. Am. Soc. Nephrol., July 1, 2003; 14(7): 1871 - 1879. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Van Biesen, O. Carlsson, R. Bergia, M. Brauner, A. Christensson, S. Genestier, M. Haag-Weber, J. Heaf, P. Joffe, A.-C. Johansson, et al. Personal dialysis capacity (PDCTM) test: a multicentre clinical study Nephrol. Dial. Transplant., April 1, 2003; 18(4): 788 - 796. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. J. A. M. Konings, J. P. Kooman, M. Schonck, D. G. Struijk, U. Gladziwa, S. J. Hoorntje, A. W. van der Wall Bake, F. M. van der Sande, and K. M. L. Leunissen Fluid status in CAPD patients is related to peritoneal transport and residual renal function: evidence from a longitudinal study Nephrol. Dial. Transplant., April 1, 2003; 18(4): 797 - 803. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. H. Chung, O. Heimburger, P. Stenvinkel, A. R. Qureshi, and B. Lindholm Association between residual renal function, inflammation and patient survival in new peritoneal dialysis patients Nephrol. Dial. Transplant., March 1, 2003; 18(3): 590 - 597. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Margetts and D. N. Churchill Acquired Ultrafiltration Dysfunction in Peritoneal Dialysis Patients J. Am. Soc. Nephrol., November 1, 2002; 13(11): 2787 - 2794. [Full Text] [PDF]
|
|
|
|
|
|
H. Schiffl, S. M. Lang, and R. Fischer Ultrapure dialysis fluid slows loss of residual renal function in new dialysis patients Nephrol. Dial. Transplant., October 1, 2002; 17(10): 1814 - 1818. [Abstract] [Full Text] [PDF]
|
|