Effluent Free Radicals Are Associated with Residual Renal Function and Predict Technique Failure in Peritoneal Dialysis Patients

Morinaga, Hiroshi; Sugiyama, Hiroshi; Inoué, Takao; Takiue, Keiichi; Kobayashi, Yôko; Kitagawa, Masashi; Akagi, Shigeru; Nakao, Kazushi; Maeshima, Yohei; Miyazaki, Ikuko; Asanuma, Masato; Hiramatsu, Masayuki; Makino, Hírofumi

doi:10.3747/pdi.2011.00032

Cited by 18 publications

(26 citation statements)

References 34 publications

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“…The fractional excretion of this nucleotide is increased in CKD patients because of the adaptive suppression of tubular reabsorption capacity (31). Recent studies indicate that preservation of residual renal function (RRF) has a beneficial effect in reducing the oxidative and carbonyl stress in PD patients (32,33). Given that most of our PD patients had some RRF, but that the HD patients were essentially all functionally anuric, it is reasonable to assume that urinary excretion of 8-OHdG in the PD patients could have contributed to lower serum levels.…”

Section: Discussionmentioning

confidence: 99%

Oxidative Dna Damage and Mortality in Hemodialysis and Peritoneal Dialysis Patients

Watanabe

Qureshi

et al. 2015

Perit Dial Int

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Section: Discussionmentioning

confidence: 99%

Oxidative Dna Damage and Mortality in Hemodialysis and Peritoneal Dialysis Patients

Watanabe

Qureshi

et al. 2015

Perit Dial Int

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“…The Spearman rank correlation was used to determine the correlations between two variables. A multiple logistic regression analysis was applied to test the independent links between the vascular function and potential functional correlates of the outcome variables [71], [72]. A multivariable logistic regression analysis was performed to determine the predictors of baPWV.…”

Section: Methodsmentioning

confidence: 99%

A Decreased Level of Serum Soluble Klotho Is an Independent Biomarker Associated with Arterial Stiffness in Patients with Chronic Kidney Disease

et al. 2013

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BackgroundKlotho was originally identified in a mutant mouse strain unable to express the gene that consequently showed shortened life spans. In humans, low serum Klotho levels are related to the prevalence of cardiovascular diseases in community-dwelling adults. However, it is unclear whether the serum Klotho levels are associated with signs of vascular dysfunction such as arterial stiffness, a major determinant of prognosis, in human subjects with chronic kidney disease (CKD).MethodsWe determined the levels of serum soluble Klotho in 114 patients with CKD using ELISA and investigated the relationship between the level of Klotho and markers of CKD-mineral and bone disorder (CKD-MBD) and various types of vascular dysfunction, including flow-mediated dilatation, a marker of endothelial dysfunction, ankle-brachial pulse wave velocity (baPWV), a marker of arterial stiffness, intima-media thickness (IMT), a marker of atherosclerosis, and the aortic calcification index (ACI), a marker of vascular calcification.ResultsThe serum Klotho level significantly correlated with the 1,25-dihydroxyvitamin D level and inversely correlated with the parathyroid hormone level and the fractional excretion of phosphate. There were significant decreases in serum Klotho in patients with arterial stiffness defined as baPWV≥1400 cm/sec, atherosclerosis defined as maximum IMT≥1.1 mm and vascular calcification scores of ACI>0%. The serum Klotho level was a significant determinant of arterial stiffness, but not endothelial dysfunction, atherosclerosis or vascular calcification, in the multivariate analysis in either metabolic model, the CKD model or the CKD-MBD model. The adjusted odds ratio of serum Klotho for the baPWV was 0.60 (p = 0.0075).ConclusionsDecreases in the serum soluble Klotho levels are independently associated with signs of vascular dysfunction such as arterial stiffness in patients with CKD. Further research exploring whether therapeutic approaches to maintain or elevate the Klotho level could improve arterial stiffness in CKD patients is warranted.

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“…In the light of studies that reported that for every 1 ml/min increase in residual renal function (RRF) in a peritoneal dialysis (PD) cohort there was a 50% reduction in the risk of death 1 and that a 250-ml increase in daily urine output was associated with a 36% reduction in mortality (reanalysis of the CANUSA study 2 ), preservation of RRF has become one of the most important goals in the long-term management of the patients on PD. Loss of RRF has subsequently been shown to be associated with many complications of chronic uremia: protein-energy wasting, [3][4][5][6] hyperphosphatemia, 6,7 left ventricular hypertrophy, 3,6,8 arterial stiffness, 9 anemia, 3,5,6 inflammation, 8 a poorer quality of life, 10,11 technique failure, 12 and ultimately patient death. 1,6,13,14 One of the strengths of PD is that this modality is associated with greater preservation of RRF when compared with hemodialysis (HD).…”

mentioning

confidence: 99%

Extracellular volume expansion, measured by multifrequency bioimpedance, does not help preserve residual renal function in peritoneal dialysis patients

McCafferty

Fan

Davenport

2014

Kidney International

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Residual renal function is a major survival determinant for peritoneal dialysis patients. Hypovolemia can cause acute kidney injury and loss of residual renal function, and it has been suggested that patients receiving peritoneal dialysis should preferably be maintained hypervolemic to preserve residual renal function. Here we determined whether hydration status predicted long-term changes in residual renal function. Changes in residual renal function and extracellular water (ECW) to total body water (TBW) measured by multifrequency bioimpedance in 237 adult patients who had paired baseline and serial 12 monthly measurements were examined. Baseline hydration status (ECW/TBW) was not significantly associated with preservation of residual renal function, unlike baseline and follow-up mean arterial blood pressure. When the cohort was split into tertiles according to baseline hydration status, there was no significant correlation seen between change in hydration status and subsequent loss in residual renal function. Increased ECW/TBW in peritoneal dialysis patients was not associated with preservation of residual renal function. Similarly, increments and decrements in ECW/TBW were not associated with preservation or reduction in residual renal function. Thus, our study does not support the view that overhydration preserves residual renal function and such a policy risks the consequences of persistent hypervolemia.

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Effluent Free Radicals Are Associated with Residual Renal Function and Predict Technique Failure in Peritoneal Dialysis Patients

Cited by 18 publications

References 34 publications

Oxidative Dna Damage and Mortality in Hemodialysis and Peritoneal Dialysis Patients

Oxidative Dna Damage and Mortality in Hemodialysis and Peritoneal Dialysis Patients

A Decreased Level of Serum Soluble Klotho Is an Independent Biomarker Associated with Arterial Stiffness in Patients with Chronic Kidney Disease

Extracellular volume expansion, measured by multifrequency bioimpedance, does not help preserve residual renal function in peritoneal dialysis patients

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