Importance of dialysis adequacy in mortality and morbidity of Chinese CAPD patients

Abstract

Our results show that dialysis adequacy has significant impact on outcome of Asian CAPD patients. Although we have excellent medium-term patient and technique survival, this favorable outcome should not prevent health care workers from providing adequate dialysis to Asian patients. The reason of discrepancy in outcome between Asian and Caucasian dialysis patients requires further study.

Oral Sodium Bicarbonate for the Treatment of Metabolic Acidosis in Peritoneal Dialysis Patients

“…However, even when the value was corrected with the formulae suggested by Joseph et al (26), serum albumin was still low in our subjects. Similar observation was made in our previous studies on peritoneal dialysis adequacy (13,27), but the cause of this discrepancy was not clear.…”

“…However, the effect of bicarbonate supplement in CAPD patients with Kt/V Ͻ2.1 has not been studied. It is important to note that although a weekly Kt/V of 2.1 was often regarded as the target of dialysis adequacy (12), we found that Chinese CAPD patients with a Kt/V of 1.7 had excellent outcome (13). The ADEMEX study further showed that increases in peritoneal Kt/V from 1.62 to 2.13 had no effect on patient survival (5).…”

“…No patient had amino acid or glucose polymer-based peritoneal dialysis solution. Dialysis prescription was changed only when there was clinical evidence of underdialysis (13). We documented the following during each follow-up visit: body weight, BP, presence of edema (semiquantitative score from 0 to 3ϩ), drug compliance by pill count, and compliance to dialysis exchange by direct questioning.…”

Is the Declining Use of Long-Term Peritoneal Dialysis Justified by Outcome Data?

“…The relationship between residual renal function and survival of prevalent PD patients, first reported by Maiorca et al (41), has now been repeatedly confirmed (42)(43)(44)(45)(46). These findings were further corroborated by the re-analysis of the Canada-USA (CANUSA) study wherein each 5-L/wk per 1.73 m 2 higher mean of urea and creatinine clearances was associated with a 12% decrease in the relative risk for death (47).…”

Novel Equations for Estimating Lean Body Mass in Peritoneal Dialysis Patients

“…Additionally, we assessed the prognostic values of LBM in all-cause mortality risk in a large retrospective PD cohort study because LBM should be a significant predictor of outcome events in PD patients (3,(8)(9)(10).…”