Nephrology Dialysis Transplantation, Vol 13, Issue 4 962-968, Copyright © 1998 by Oxford University Press
S Davies, L Phillips and G Russell
Background: Loss of residual renal function has a
profound effect on the survival of peritoneal dialysis patients. Less is
known of the impact of peritoneal function. The purpose of this study was
to investigate the influence of solute transport on clinical outcome in
CAPD patients. Methods: Two hundred and ten
consecutive patients commencing CAPD since 1990 were enrolled into a single
centre prospective longitudinal observational study of urea, protein, and
peritoneal kinetics. On entry, and at 6-monthly intervals, estimations were
made of weight, body mass index (BMI), plasma albumin, Kt/V, residual renal
function (RRF), NPCR, low-molecular-weight solute transport (D/Pcreat), and
peritoneal protein losses. All patients were censored in 1996, regardless
of treatment modality. Results: During the 6-year
follow up period (median 22 months) there were 51 deaths, and the actuarial
survival was 58% at 5 years. Urea, protein and peritoneal kinetics varied
with time on dialysis: as anticipated there was a reduction in Kt/V,
attributable to loss of RRF, whereas plasma albumin was stable for the
first 2 years of treatment, but subsequently started to decline, a trend
that became significant at 42 months. Peritoneal kinetics stabilized within
the first 6 months of treatment and then showed a trend of increased solute
transfer with time on treatment, which became significant by the end of the
study. Comparing survivors with non-survivors Kt/V and RRF were similar at
the start of treatment, but loss of RRF occurred significantly earlier in
non-survivors than survivors (0.37vs 0.68, P=0.02 at 6
months, 0.19 vs 0.54, P=0.01 at 12 months). D/Pcreat
was also identical at commencement of treatment, but subsequently whilst
survivors had stable solute transfer non-survivors had consistently higher
solute transfer beyond 6 months that reached increasing significance after
18 months, (0.70 vs 0.67, P=0.05 at 18 months, 0.72
vs 0.66, P=0.03 at 24 months). A Cox proportional
hazard model constructed for the variables age, sex, BMI, albumin, Kt/V and
D/Pcreat at 6 months of treatment indicated that low Kt/V (P=0.0004), high
D/Pcreat (P=0.013) and age (P=0.028) were independent predictors of death.
Conclusion: There is good reason to believe that high
peritoneal solute transport is an independent marker of poor outcome in
CAPD patients. Key words: peritoneal solute transport;
Kt/V; residual renal function; survival; albumin; peritoneal dialysis
ORIGINAL ARTICLES
Peritoneal solute transport predicts survival on CAPD independently of residual renal function
Department of Nephrology, North Staffordshire Hospital Trust, Princes Road, Hartshill, Stoke-on-Trent ST5 0PP, UK; Corresponding author
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  T. P. Moraes, R. Pecoits-Filho, S. C. Ribeiro, M. Rigo, M. M. Silva, P. S. Teixeira, D. D. Pasqual, R. Fuerbringer, and M. C. Riella PERITONEAL DIALYSIS IN BRAZIL: TWENTY-FIVE YEARS OF EXPERIENCE IN A SINGLE CENTER Perit. Dial. Int., September 1, 2009; 29(5): 492 - 498. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C.-T. Liao, Y.-M. Chen, C.-C. Shiao, F.-C. Hu, J.-W. Huang, T.-W. Kao, H.-F. Chuang, K.-Y. Hung, K.-D. Wu, and T.-J. Tsai Rate of decline of residual renal function is associated with all-cause mortality and technique failure in patients on long-term peritoneal dialysis Nephrol. Dial. Transplant., September 1, 2009; 24(9): 2909 - 2914. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. J. Davies Preserving residual renal function in peritoneal dialysis: volume or biocompatibility? Nephrol. Dial. Transplant., September 1, 2009; 24(9): 2620 - 2622. [Full Text] [PDF]
|
|
|
|
 |
|
 J. Perl, K. Huckvale, M. Chellar, B. John, and S. J. Davies Peritoneal Protein Clearance and not Peritoneal Membrane Transport Status Predicts Survival in a Contemporary Cohort of Peritoneal Dialysis Patients Clin. J. Am. Soc. Nephrol., July 1, 2009; 4(7): 1201 - 1206. [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]
|
|
|
|
|
|
T. Hasegawa, A. Yoshimura, M. Hirose, D. Komukai, H. Tayama, S. Watanabe, F. Koiwa, S. Yamazaki, and T. Ideura A STRICT LOW PROTEIN DIET DURING THE PREDIALYSIS PERIOD SUPPRESSES PERITONEAL PERMEABILITY AT INDUCTION OF PERITONEAL DIALYSIS Perit. Dial. Int., May 1, 2009; 29(3): 319 - 324. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Liakopoulos and N. Dombros PATIENT SELECTION FOR AUTOMATED PERITONEAL DIALYSIS: FOR WHOM, WHEN? Perit. Dial. Int., February 1, 2009; 29(Supplement_2): S102 - S107. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Khawar, K. Kalantar-Zadeh, W. K. Lo, D. Johnson, and R. Mehrotra Is the Declining Use of Long-Term Peritoneal Dialysis Justified by Outcome Data? Clin. J. Am. Soc. Nephrol., November 1, 2007; 2(6): 1317 - 1328. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. J. Wiggins, S. P. McDonald, F. G. Brown, J. B. Rosman, and D. W. Johnson High membrane transport status on peritoneal dialysis is not associated with reduced survival following transfer to haemodialysis Nephrol. Dial. Transplant., October 1, 2007; 22(10): 3005 - 3012. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. T. Krediet 30 YEARS OF PERITONEAL DIALYSIS DEVELOPMENT: THE PAST AND THE FUTURE Perit. Dial. Int., June 1, 2007; 27(Supplement_2): S35 - S41. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. de Jonge, B. Bammens, W. Lemahieu, B. D. Maes, and Y. Vanrenterghem Comparison of peritoneal dialysis and haemodialysis after renal transplant failure Nephrol. Dial. Transplant., June 1, 2006; 21(6): 1669 - 1674. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M. Sherif, M. Nakayama, Y. Maruyama, H. Yoshida, H. Yamamoto, K. Yokoyama, and M. Kawakami Quantitative assessment of the peritoneal vessel density and vasculopathy in CAPD patients Nephrol. Dial. Transplant., June 1, 2006; 21(6): 1675 - 1681. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. V. Badve, C. M. Hawley, S. P. McDonald, D. W. Mudge, J. B. Rosman, F. G. Brown, D. W. Johnson, and for The ANZDATA Registry PD Working Committee Effect of previously failed kidney transplantation on peritoneal dialysis outcomes in the Australian and New Zealand patient populations Nephrol. Dial. Transplant., March 1, 2006; 21(3): 776 - 783. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Rumpsfeld, S. P. McDonald, and D. W. Johnson Higher Peritoneal Transport Status Is Associated with Higher Mortality and Technique Failure in the Australian and New Zealand Peritoneal Dialysis Patient Populations J. Am. Soc. Nephrol., January 1, 2006; 17(1): 271 - 278. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Schulman Mortality and Treatment Modality of End-Stage Renal Disease Ann Intern Med, August 2, 2005; 143(3): 229 - 231. [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]
|
|
|
|
|
|
R. B. Asghar, A. M. Diskin, P. Spanel, D. Smith, and S. J. Davies Influence of Convection on the Diffusive Transport and Sieving of Water and Small Solutes across the Peritoneal Membrane J. Am. Soc. Nephrol., February 1, 2005; 16(2): 437 - 443. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Westhuyzen, K. Mills, and H. Healy Predicting Clinical Outcomes in Peritoneal Dialysis Patients Using Small Solute Modeling Ann. Clin. Lab. Sci., January 1, 2005; 35(1): 46 - 53. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. A. Brown, S. J. Davies, P. Rutherford, F. Meeus, M. Borras, W. Riegel, J. C. Divino Filho, E. Vonesh, and M. Van Bree Survival of Functionally Anuric Patients on Automated Peritoneal Dialysis: The European APD Outcome Study J. Am. Soc. Nephrol., November 1, 2003; 14(11): 2948 - 2957. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Termorshuizen, J. C. Korevaar, F. W. Dekker, K. J. Jager, J. G. van Manen, E. W. Boeschoten, and R. T. Krediet Time trends in initiation and dose of dialysis in end-stage renal disease patients in The Netherlands Nephrol. Dial. Transplant., March 1, 2003; 18(3): 552 - 558. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Bakewell, R. Higgins, and M. Edmunds Nutrition, adequacy of dialysis, and clinical outcome in Indo-Asian and White European patients on peritoneal dialysis QJM, December 1, 2002; 95(12): 811 - 820. [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]
|
|
|
|
|
|
R. T. Krediet The rise and fall of the Kt/V concept in CAPD Nephrol. Dial. Transplant., June 1, 2002; 17(6): 970 - 972. [Full Text] [PDF]
|
|
|
|
|
|
A. Fu{beta}holler, S. zur Nieden, B. Grabensee, and J. Plum Peritoneal Fluid and Solute Transport: Influence of Treatment Time, Peritoneal Dialysis Modality, and Peritonitis Incidence J. Am. Soc. Nephrol., April 1, 2002; 13(4): 1055 - 1060. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. H. Chung, O. Heimburger, P. Stenvinkel, J. Bergstrom, and B. Lindholm Association between inflammation and changes in residual renal function and peritoneal transport rate during the first year of dialysis Nephrol. Dial. Transplant., November 1, 2001; 16(11): 2240 - 2245. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. BARGMAN, K. E. THORPE, and D. N. CHURCHILL Relative Contribution of Residual Renal Function and Peritoneal Clearance to Adequacy of Dialysis: A Reanalysis of the CANUSA Study J. Am. Soc. Nephrol., October 1, 2001; 12(10): 2158 - 2162. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. J. DAVIES, L. PHILLIPS, P. F. NAISH, and G. I. RUSSELL Peritoneal Glucose Exposure and Changes in Membrane Solute Transport with Time on Peritoneal Dialysis J. Am. Soc. Nephrol., May 1, 2001; 12(5): 1046 - 1051. [Abstract] [Full Text]
|
|
|
|
|
|
S. J. Davies Peritoneal solute transport--we know it is important, but what is it? Nephrol. Dial. Transplant., August 1, 2000; 15(8): 1120 - 1123. [Full Text] [PDF]
|
|
|
|
|
|
F. SCHAEFER, G. KLAUS, and O. MEHLS Peritoneal Transport Properties and Dialysis Dose Affect Growth and Nutritional Status in Children on Chronic Peritoneal Dialysis J. Am. Soc. Nephrol., August 1, 1999; 10(8): 1786 - 1792. [Abstract] [Full Text]
|
|