Daily peritoneal ultrafiltration predicts patient and technique survival in anuric peritoneal dialysis patients

Lin, Xinghui; Lin, Aiwu; Ni, Zhaohui; Yao, Qiang; Zhang, Weimin; Yan, Yucheng; Fang, Wei; Gu, Aiping; Axelsson, Jonas; Qian, Jiaqi

doi:10.1093/ndt/gfq001

Cited by 34 publications

(25 citation statements)

References 25 publications

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“…They conducted a retrospective study in 150 anuric CAPD patients with a mean follow-up of 57.7 months after anuria and showed that D/P Cr was a strong independent predictor for mortality, but the results regarding the UF volume of patients was unclear. Similar results were shown in another retrospective study that included 86 Chinese anuric CAPD patients with a median follow-up of 25.3 months, such that although D/P Cr was not associated with mortality after adjustment for confounders, the mortality risk was significantly reduced when baseline UF was increased above 1 l/24 h [12] . Furthermore, the EAPOS study, which was a 2-year prospective multicenter study consisting of 177 anuric patients treated with APD, suggested that peritoneal solute transport status at baseline did not influence patient, technique or combined patient and technique survival, whereas baseline UF below the 750 ml/24 h was associated with poor survival [4] .…”

Section: Discussionsupporting

confidence: 86%

“…Moreover, the association between peritoneal membrane status and mortality in anuric patients who are on PD has been poorly investigated. One analysis for 86 anuric continuous ambulatory peritoneal dialysis (CAPD) patients demonstrated that each 0.1 increment of dialysate to plasma creatinine ratio (D/P Cr) was not associated with either patient survival or technique survival [12] . In contrast, a study from Hong Kong reported that higher D/P Cr level (RR = 1.505 for every 0.1 increase, 95% CI 1.202-1.885, p value = 0.000) was associated with an increased risk of all-cause mortality in anuric CAPD patients [13] .…”

Section: Introductionmentioning

confidence: 99%

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Faster Transport Status and Mortality in Anuric Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

Xiong¹,

Fan²,

Xu³

et al. 2015

Blood Purif

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Background: There are limited data regarding the relationship between transport status and mortality in anuric continuous ambulatory peritoneal dialysis (CAPD) patients. Methods: According to the dialysate to plasma creatinine ratio (D/P Cr), 292 anuric CAPD patients were stratified to faster (D/P Cr ≥0.65) and slower transport groups (D/P Cr <0.65). The Cox proportional hazards models were used to evaluate the association of transport status with mortality. Results: During a median follow-up of 22.1 months, 24% patients died, 61.4% of them due to cardiovascular disease (CVD). Anuric patients with faster transport were associated with an increased risk of all-cause mortality (HR (95% CI) = 2.16 (1.09-4.26)), but not cardiovascular mortality, after adjustment for confounders. Faster transporters with pre-existing CVD had a greater risk for death compared to those without any history of CVD. Conclusion: Faster transporters were independently associated with high all-cause mortality in anuric CAPD patients. This association was strengthened in patients with pre-existing CVD.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Faster Transport Status and Mortality in Anuric Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

Xiong¹,

Fan²,

Xu³

et al. 2015

Blood Purif

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“…As accumulating evidence has found that fluid status strongly influences the clinical outcome of dialysis patients [17,18,19,20], we believe that patients who have too much interdialytic weight gain are not suitable for twice-weekly HD even when a very high spKt/V could be ensured, and for these patients, a timely switch from twice-weekly HD to thrice-weekly HD may be important.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcome of Twice-Weekly Hemodialysis Patients in Shanghai

Lin

Yan

et al. 2011

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Background: Twice-weekly hemodialysis (HD) is prevalent in the developing countries and the clinical outcome of this population remains to be elucidated. Methods: Data were collected from Shanghai Renal Registry. 2,572 patients undergoing regular HD in Shanghai on January 2007 were enrolled into the cohort study with 2 years’ follow-up. Clinical and HD parameters obtained from the network were utilized to compare twice-weekly with thrice-weekly HD. Results: Compared with patients on thrice-weekly HD, the twice-weekly HD patients were significantly younger and had significantly longer HD session time, higher single-pool Kt/V (spKt/V) but shorter HD vintage (p < 0.001). Kaplan-Meier survival analysis indicated that the two groups had similar survival. Multivariate Cox regression analysis showed that age, body mass index, serum albumin and weekly Kt/V were predictors of patient mortality. Conclusions: The similar survival between twice-weekly HD and thrice-weekly HD is likely relating to patient selection; dialysis adequacy of twice-weekly HD remains to be elucidated.

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“…[2][3][4][5][6][7][8] But there are no clear-cut criteria for the diagnosis of hypovolemia or hypervolemia. Some patients have elevated systolic blood pressure, despite being euvolemic which is thought to be due to vascular stiffness.…”

Section: Discussionmentioning

confidence: 99%

“…For both the treatment modalities, international guidelines underline volume status for dialysis adequacy. 1 One of the main factors determining the morbidity and mortality in PD patients is volume status [2][3][4][5][6][7] and may even be more important than solute clearance. 8 Besides clinical findings (blood pressure, presence of edema, and weight gain), echocardiography, Dual Energy X-ray Absorptiometry (DEXA), direct measurement of extracellular and total body water (TBW), brain natriuretic peptide (BNP) has been used for the determination of hydration status.…”

Section: Introductionmentioning

confidence: 99%

Volume Status in Patients on Peritoneal Dialysis: The Role of Apelin and Bio-Impedance Spectroscopy

et al. 2012

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One of the main factors determining the survival of peritoneal dialysis (PD) patients is volume status. We aimed to investigate hydration status of PD patients by bio-impedance spectroscopy (BIS) and echocardiography and to study the relation of them with apelin, which has effects related with volume status like vasodilation, positive inotropism, and inhibition of ADH release and RAS antagonism. Chronic PD patients without active cardiac disease or clinically prominent hypervolemia were included. Besides the demographic, clinical, and laboratory data, BIS and echocardiographic findings together with apelin levels were recorded. The study included 21 patients. Of them, eight patients were euvolemic, one patient was hypovolemic, and others have some degree of overhydration (1.1-6.8 L) with BIS, although all were euvolemic clinically. Mean apelin level was 1.49 AE 0.49 ng/mL. Apelin level was positively correlated with ejection fraction and negatively with total body water (TBW), intracellular and extracellular water, lean tissue mass, and left atrium diameter. On linear regression model, TBW was the major determinant of apelin. Although apelin is expected to increase in hypervolemic patients, the negative correlation with body water in this study may be related with yet unknown role of apelin in dialyzed patients. They may have important roles in volume status in future.

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Daily peritoneal ultrafiltration predicts patient and technique survival in anuric peritoneal dialysis patients

Abstract: The present study demonstrates a strong predictive value of daily peritoneal UF for both technique and patient survival in prevalent anuric PD patients. Identifying markers of satisfactory fluid status, as well as optimizing therapy to meet UF goals, remains an important clinical target.

Cited by 34 publications

References 25 publications

Faster Transport Status and Mortality in Anuric Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

Faster Transport Status and Mortality in Anuric Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

Clinical Outcome of Twice-Weekly Hemodialysis Patients in Shanghai

Volume Status in Patients on Peritoneal Dialysis: The Role of Apelin and Bio-Impedance Spectroscopy

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