Cross-sectional Assessment of Weekly Urea and Creatinine Clearances in Patients on Continuous Ambulatory Peritoneal Dialysis

Nolph, Karl D.; Moore, Harold L.; Twardowski, Zbylut J.; Khanna, Ramesh; Prowant, Barbara F.; Meyer, Marianne; Ponferrada, Leonor

doi:10.1097/00002480-199207000-00004

Cited by 150 publications

(78 citation statements)

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“…Total Kt/V was calculated as the sum of renal and peritoneal Kt/V. Glomerular filtration rate was calculated as the average of 24-hour urinary creatinine clearance and urea clearance (Nolph et al 1993), and was normalized for body surface area obtained by the Du Bois and Du Bois equation (Du Bois and Du Bois 1989).…”

Section: Methodsmentioning

confidence: 99%

Residual Urinary Volume Is a Predictor of Overhydration in Patients on Peritoneal Dialysis

Jung

Sung

Han

et al. 2014

Tohoku J. Exp. Med.

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Fluid overload is linked to hypertension and cardiovascular diseases in patients on peritoneal dialysis (PD). It is important to monitor the residual urinary volume in patients with end-stage renal disease (ESRD). In fact, fluid overload and residual urinary volume have been considered the risk factors of mortality in ESRD patients on PD. However, the relationship between residual urinary volume and fluid overload was still controversial. Therefore, the objective of this cross-sectional study was to evaluate the association between residual urinary volume and the volume status of PD patients. Body composition was measured using a portable multifrequency whole-body bioimpedance assessment. Relative overhydration was defined when the ratio of overhydration to extracellular water was > 0.15. We examined 75 patients, with a mean age of 50.7 years and mean body mass index of 23.5 kg/m 2 . Dialysis vintage was 46.5 months. The patients were divided into the anuric group (n = 30; urine output ≤ 100 mL/day) and the group of urine output > 100 mL/day (n = 45). The anuric group showed higher degree of relative overhydration compared to the patients with the urine output of > 100 mL/day (p = 0.020). In a multivariable linear regression analysis, anuria, diabetes, and serum albumin level were independently associated with relative overhydration. In conclusion, volume status should be closely monitored in anuric patients, and the preservation of residual urinary volume is one of important goals to maintain volume status in PD patients.

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Section: Methodsmentioning

confidence: 99%

Residual Urinary Volume Is a Predictor of Overhydration in Patients on Peritoneal Dialysis

Jung

Sung

Han

et al. 2014

Tohoku J. Exp. Med.

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“…Weekly Kt/V was determined using standard methods (12). Residual renal function was calculated as the average of 24-hour urinary urea and creatinine, as described elsewhere (13).…”

Section: Derived Insulin Resistance Indicesmentioning

confidence: 99%

Insulin Resistance in Nondiabetic Peritoneal Dialysis Patients

Bernardo

Oliveira

Santos³

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objectives Insulin resistance has been associated with cardiovascular disease in peritoneal dialysis patients. Few studies have addressed the impact of fast transport status or dialysis prescription on insulin resistance. The aim of this study was to test whether insulin resistance is associated with obesity parameters, peritoneal transport rate, and glucose absorption.Design, setting, participants, & measurements Insulin resistance was evaluated with homeostasis model assessment method (HOMA-IR), additionally corrected by adiponectin (HOMA-AD). Enrolled patients were prevalent nondiabetics attending at Santo António Hospital Peritoneal Dialysis Unit, who were free of hospitalization or infectious events in the previous 3 months (51 patients aged 50.4615.9 years, 59% women). Leptin, adiponectin, insulin-like growth factor-binding protein 1 (IGFBP-1), and daily glucose absorption were also measured. Lean tissue index, fat tissue index (FTI), and relative fat mass (rel.FM) were assessed using multifrequency bioimpedance. Patients were categorized according to dialysate to plasma creatinine ratio at 4 hours, 3.86% peritoneal equilibration test, and obesity parameters.Results Obesity was present in 49% of patients according to rel.FM. HOMA-IR correlated better with FTI than with body mass index. Significant correlations were found in obese, but not in nonobese patients, between HOMA-IR and leptin, leptin/adiponectin ratio (LAR), and IGFBP-1. HOMA-IR correlated with HOMA-AD, but did not correlate with glucose absorption or transport rate. There were no significant differences in insulin resistance indices, glucose absorption, and body composition parameters between fast and nonfast transporters. A total of 18 patients (35.3%) who had insulin resistance presented with higher LAR and rel. FM (7.3 [12.3, interquartile range] versus 0.7 [1.4, interquartile range], P,0.001, and 39.4610.1% versus 27.2611.5%, P=0.002, respectively), lower IGFBP-1 (8.267.2 versus 21.0616.3 ng/ml, P=0.002), but similar glucose absorption and small-solute transport compared with patients without insulin resistance. FTI and LAR were independent correlates of HOMA-IR in multivariate analysis adjusted for glucose absorption and small-solute transport (r=0.82, P,0.001).Conclusions Insulin resistance in nondiabetic peritoneal dialysis patients is associated with obesity and LAR independent of glucose absorption and small-solute transport status. Fast transport status was not associated with higher likelihood of obesity or insulin resistance.

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“…Twenty-four hour urine and dialysate was collected for measurement of residual GFR and total weekly urea and creatinine clearance using standard methods (7,8). The transport status of the peritoneal membrane was characterized by a standard peritoneal equilibration test using a 4-hour dwell of a 2.27% glucose-containing PD solution.…”

Section: Assessment Of Residual Renal Function and Dialysis Indicesmentioning

confidence: 99%

Heart Failure in Long-Term Peritoneal Dialysis Patients

Wang¹,

Wang²,

Lam³

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Heart failure occurs frequently in end-stage renal disease patients. However, there are no prospective, longitudinal follow-up data on its prevalence, severity, and risk factors in longterm peritoneal dialysis (PD) patients.Design, setting, participants, & measurements A prospective observational study was conducted in 220 longterm PD patients followed up for 4 years or until death. Echocardiography was obtained at baseline. Primary study end points were heart failure and mortality.Results Eighty-six patients had a previous history of heart failure at study entry. The cumulative 4-year survival probability was 37.4% and 64.7% for patients with and without previous heart failure, respectively (P Ͻ 0.0001). During follow-up, 87 patients (40.9%) developed heart failure, of which 53 were recurrence and 34 were new-onset heart failure. Diabetes, background atherosclerotic vascular disease, systolic hypertension, left ventricular (LV) mass index, systolic dysfunction, and hypoalbuminemia were significant risk factors predicting heart failure in the entire cohort. Diabetes and LV mass and volume index were significant predictors of new-onset heart failure. Systolic hypertension, LV volume index, and hypoalbuminemia were significant predictors of recurrent heart failure.Conclusions Heart failure is a highly prevalent complication in long-term PD patients and predicts adverse clinical outcomes. More attention should be focused on improving BP and volume control and identifying treatment strategies that effectively lower atherosclerotic burden and reverse LV hypertrophy, remodeling, and systolic dysfunction in PD patients.

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Cross-sectional Assessment of Weekly Urea and Creatinine Clearances in Patients on Continuous Ambulatory Peritoneal Dialysis

Cited by 150 publications

References 0 publications

Residual Urinary Volume Is a Predictor of Overhydration in Patients on Peritoneal Dialysis

Residual Urinary Volume Is a Predictor of Overhydration in Patients on Peritoneal Dialysis

Insulin Resistance in Nondiabetic Peritoneal Dialysis Patients

Heart Failure in Long-Term Peritoneal Dialysis Patients

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