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Background and Aims The study aims to explore the relationship between a "comprehensive 2-day in-hospital assessment management mode” (C2IAMM) and survival and technical survival rates of patients undergoing peritoneal dialysis (PD). Method Eight hundred and thirty PD patients were retrospectively analyzed from January 1, 2011, to October 31, 2017. The “C2IAMM” includes admitting patients undergoing PD to the hospital for 2 days for various assessments. Based on these results, comprehensive interventions was provided. The 1-year, 3-year and 5-year survival and technical survival rates of patients following the C2IAMM were analyzed, and subgroup analysis were further performed. Results The 830 PD patients following C2IAMM achieved 1-year, 3-year and 5-year survival rates of 98.0%, 91.4% and 84.3%, respectively; the corresponding technical survival rates were 97.1%, 87.1% and 80.5%. The subgroup analysis showed that age ≥ 60 years, diabetes mellitus, cardiovascular and cerebrovascular diseases, and respiratory diseases (all P < 0.001) were associated with survival. Conclusion This article implies that the C2IAMM may be associated with higher survival and technical survival.

<b><i>Introduction:</i></b> Some biomarkers in drained dialyzate or peritoneal membrane have been found related to the dialyzate/plasma ratio of creatinine at 4 h (D/P Cr) in patients undergoing peritoneal dialysis (PD). But so far, there is no report on serum markers. Some biomarkers are associated with cardiovascular diseases (CVDs). Chemerin is a multifunctional chemoattractant adipokine which plays important roles in inflammation, adipogenesis, and metabolism. We intended to investigate the role of chemerin in the peritoneal membrane transport function and CVDs in incident PD patients. <b><i>Methods:</i></b> This prospective cohort study was conducted in our PD center. The patients underwent initial standardized peritoneal equilibration test after PD for 4–6 weeks. Level of serum chemerin was determined via enzyme-linked immunosorbent assay. The patients’ CVDs were recorded during the follow-up period. <b><i>Results:</i></b> 151 eligible patients with a mean age of 46.59 ± 13.52 years were enrolled, and the median duration of PD was 25.0 months. The median concentration of serum chemerin was 29.09 ng/mL. Baseline D/P Cr was positively correlated with serum chemerin (<i>r</i> = 0.244, <i>p</i> = 0.003). The multivariate analyses revealed that serum chemerin (<i>p</i> = 0.002), age (<i>p</i> = 0.041), albumin (<i>p</i> = 0.000), and high-density lipoprotein (<i>p</i> = 0.022) were independent factors of D/P Cr. The serum chemerin level was significantly higher in diabetes mellitus (DM) patients than that of patients without DM (36.45 ng/mL vs. 27.37 ng/mL, <i>p</i> = 0.000), and there was a significant statistical difference in CVDs between the high chemerin group (≥29.09 ng/mL) and low chemerin group (&lt;29.09 ng/mL) (42 vs. 21%, <i>p</i> = 0.009). <b><i>Conclusions:</i></b> Serum chemerin has a positive correlation with baseline D/P Cr in incident PD patients. It may be a biomarker that can predict the baseline transport function of the peritoneal membrane, and serum chemerin may be a risk factor of CVDs for incident PD patients. Multicenter studies with a larger sample size are warranted in the future.

BACKGROUND AND AIMS Peritoneal dialysis (PD) is a well-established renal replacement therapy for patients with end-stage renal disease. The peritoneal equilibration test (PET) is widely used for assessing peritoneal solute transport. Recently, the International Society for PD committee recommended performing PET with 4.25% dextrose solution instead of traditional 2.5% dextrose solution to provide better information on ultrafiltration capacity. This study aims to explore the peritoneal transport characteristics, sodium sieving and electrolyte clearance with PET-4.25%. METHOD We conducted a cross-sectional study in PD patients treated in West China Hospital between June 2021 and December 2021. All patients underwent PET-4.25%. Peritoneal transport characteristics, sodium sieving and dialysate electrolyte clearance were analysed. RESULTS A total of 108 patients (61 males, 56%; mean age 48 ± 4 years old, median PD duration 17 months) were included. Dialysate to plasma (D/P) creatinine values at 4 h were distributed similarly in PET-2.5% and PET-4.25% (Fig. 1). The dialysate sodium decreased at the beginning of PET-4.25% and gradually increased, while other dialysate electrolyte levels continued to increase or decrease during the 4 h (Fig. 2). Most patients had their maximal sodium dip at 2 h (N = 80, 74%). The mean sodium dip at 1 h was 7.28 ± 2.93 mmol/L (sodium sieving ratio 0.057 ± 0.023), and the mean maximal sodium dip was 8.81 ± 4.18 mmol/L. In both univariate and multivariate analyses, sodium sieving was negatively correlated with 4-h D/P creatinine and glomerular filtration rate (GFR) and positively correlated with PET-4.25% ultrafiltration volume (Fig. 3). The total clearances of sodium, potassium, chloride, calcium, magnesium and phosphate with 2 L of 4.25% dextrose were 66.9 ± 22.4 mmol, 6.64 ± 1.25 mmol, 62.7 ± 27.7 mmol, 0.07 ± 0.27 mmol, 0.63 ± 0.19 mmol and 1.98 ± 0.63 mmol, respectively. The amount of electrolyte clearance was not related to peritoneal transport characteristics. Nine patients were diagnosed with ultrafiltration failure (UFF). Patients with UFF had significantly lower sodium and chloride clearance than non-UFF patients. CONCLUSION PET-4.25% could assess peritoneal transport characteristics with similar results to PET-2.5%, while it could provide more information on ultrafiltration capacity. Four-hour D/P creatinine, GFR and ultrafiltration volume are independent predictors for sodium sieving. Dialysate electrolyte clearance is not related to peritoneal transport characteristics, while sodium clearance is decreased in UFF patients.