The Prognostic Factors for Long-term Maintenance of CAPD: Importance of Early %lean Body Mass and Peritonitis.
- Author:
Dong Ki KIM
1
;
Seung Hyeok HAN
;
Jung Eun LEE
;
Sung Jin MOON
;
Hyun Wook KIM
;
Jae Hyun CHANG
;
Sun Young PARK
;
Jung Tak PARK
;
Beom Seok KIM
;
Shin Wook KANG
;
Ho Yung LEE
;
Dae Suk HAN
;
Kyu Hun CHOI
Author Information
1. Department of Internal Medicine, Yonsei University, College of Medicine, The Institute of Kidney Disease, Yonsei University, Seoul, Korea. khchoi6@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Long-term survivors;
Peritoneal dialysis;
Malnutrition;
Peritonitis
- MeSH:
Creatinine;
Dialysis;
Humans;
Linear Models;
Malnutrition;
Multivariate Analysis;
Nutritional Status;
Peritoneal Dialysis;
Peritoneal Dialysis, Continuous Ambulatory*;
Peritonitis*;
Prevalence;
Renal Dialysis;
Retrospective Studies;
Risk Factors;
Serum Albumin;
Survival Rate;
Survivors
- From:Korean Journal of Nephrology
2007;26(5):590-600
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Lower technical survival rate of CAPD compared to hemodialysis is still concerned. We aimed to evaluate the characteristics of long-term CAPD survivors in pre-dialysis and early phase of CAPD for estimating predictive markers for long-term maintenance of CAPD. METHODS: We retrospectively reviewed records of long-term CAPD patients (LT group, >100 months, n=51) and short-term patients (ST group, <50 months, n=102) who were age-sex matched with the LT group in a 2:1 ratio. Clinical characteristics, serial biochemical parameters, Kt/V, and peritoneal equilibrium test (PET) within 1 month and at 1 year of CAPD were analyzed. RESULTS: LT group had lower prevalence of diabetes, higher pre-dialysis serum albumin, creatinine, % LBM at 1 month of CAPD and lower peritonitis rate compared to ST group. However, dialysis adequacy, residual renal function and transport status showed no differences between two groups at 1 month and 1 year of CAPD. In multivariate analysis, diabetes, peritonitis rate and %LBM were independent risk factors for failure of long-term maintenance of CAPD. Moreover, patients with high %LBM were more likely to be in LT group, had longer CAPD maintenance duration, and lower peritonitis rate. In multiple linear regression analysis for risk factors associated with peritonitis, %LBM at 1 month and pre-dialysis serum albumin were independently associated with peritonitis rate. CONCLUSION: The present study revealed that non-diabetic history, higher %LBM and lower peritonitis rate are important predictors of long-term CAPD survival. Also, poor nutritional status assessed by %LBM and serum albumin level was independently associated with high frequency of peritonitis.
