Long Term Effects of Dialysis Adequacy, Residual Renal Function, Nutritional Indices on CAPD Patient Outcome.
- Author:
Hyeog Man KWON
1
;
Chan Duck KIM
;
Ji Hyeong CHO
;
Min Hwa JANG
;
Hyuk Joon CHOI
;
Hyun Chul LEE
;
Ja Yong PARK
;
Sun Hee PARK
;
Yong Lim KIM
Author Information
1. Department of Internal Medicine, College of Medicine, Kyungpook National University, Daegu, Korea. ylkim@knu.ac.kr
- Publication Type:Original Article
- Keywords:
Dialysis adequacy;
Nutritional indices;
Membrane transport characteristic;
Survival
- MeSH:
Dialysis*;
Follow-Up Studies;
Humans;
Male;
Membranes;
Nutrition Assessment*;
Peritoneal Dialysis, Continuous Ambulatory*;
Serum Albumin
- From:Korean Journal of Nephrology
2004;23(2):325-334
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Several factors including dialysis adequacy are now known to be related to clinical outcomes of CAPD patients. In our study, the long term effects of dialysis adequacy, residual renal function, nutritional indices, and peritoneal membrane transport characteristics on the outcomes of CAPD patients were evaluated. METHODS: Prevalent or incident 127 patients were enrolled from February 1998 to January 1999. Follow-up was terminated in January 2003. In 41 patients, parameters of adequacy were reevaluated, and the effects of parameter change over time on patient outcomes were analyzed. RESULTS: Seventy-two were male. Twenty-nine (23%) were diabetic. Mean age was 47+/-2.9 years, and the mean follow up period was 45+/-.8 months. The baseline serum albumin was 3.7+/-.5 g/dL. nPCR was 0.8+/-.2 g/kg/d, and %lean body mass was 68.4+/-4.3. Kt/V was 2.0+/-.7, and Ccr was 64.5+/-8.8 L/wk/1.73 m2. The estimated GFR was 1.1+/-.3 mL/min. The multivariated analysis demonstrated that diabetes, serum albumin, and the patent residual renal function were independent factors of the patient and technique survival. Membrane transport characteristic was a predictor of technique survival. Among patients for whom the parameters of adequacy were reevaluated, a more rapid decrease of serum albumin and a more rapid increase of membrane transport characteristics were associated with increased risk of either death or technique failure. CONCIUSION: Nutritional indices and presence of residual renal function have a significant impact on the clinical outcome. The decrease of serum albumin and the increase of membrane transport characteristic have negative impacts on patient and technique survival.
