Peritoneal solute transport predicts survival on CAPD independently of residual renal function

Davies, Simon; Phillips, Louise Elizabeth; Russell, G. I.

doi:10.1093/ndt/13.4.962

Cited by 197 publications

(165 citation statements)

References 1 publication

Supporting

Mentioning

156

Contrasting

Unclassified

Order By: Relevance

“…Peritoneal membrane transport status at baseline had no effect on outcome, unlike in previous studies of patients on CAPD (4,5,34). High transport status in CAPD results in poor UF with consequent fluid overload.…”

Section: Discussioncontrasting

confidence: 63%

“…The patients in this study were on continuous ambulatory peritoneal dialysis (CAPD) and had significant residual renal function, so small solute clearances achieved represented a combination of dialysis and renal clearance. The CANUSA study confirmed data from other studies (4,5) suggesting that patients on CAPD with high membrane permeability had increased mortality, possibly because of poor ultrafiltration (UF) and consequent fluid overload.…”

supporting

confidence: 82%

See 1 more Smart Citation

Survival of Functionally Anuric Patients on Automated Peritoneal Dialysis

Brown¹,

Davies²,

Rutherford³

et al. 2003

Journal of the American Society of Nephrology

347

311

View full text Add to dashboard Cite

Abstract. The European APD Outcome Study (EAPOS) is a 2-yr, prospective, multicenter study of the feasibility and clinical outcomes of automated peritoneal dialysis (APD) in anuric patients. A total of 177 patients were enrolled with a median age of 54 yr (range, 21 to 91 yr). Previous median total time on dialysis was 38 mo (range, 1.6 to 259 mo), and 36% of patients had previously been on hemodialysis for Ͼ90 d. Diabetes and cardiovascular disease were present in 17% and 46% of patients, respectively. The APD prescription was adjusted at physician discretion to aim for creatinine clearance (Ccrea) Ն60 L/wk per 1.73 m 2 and ultrafiltration (UF) Ն750 ml/24 h during the first 6 mo. Baseline solute transport status (D/P) was determined by peritoneal equilibration test. At 1 yr, 78% and 74% achieved Ccrea and UF targets, respectively; median drained dialysate volume was 16.2 L/24 h with 50% of patients using icodextrin. Baseline D/P was not related to UF achieved at 1 yr. At 2 yr, patient survival was 78% and technique survival was 62%. Baseline predictors of poor survival were age (Ͼ65 yr; P ϭ 0.006), nutritional status (Subjective Global Assessment grade C; P ϭ 0.009), diabetic status (P ϭ 0.008), and UF (Ͻ750 ml/24 h; P ϭ 0.047). Time-averaged analyses showed that age, Subjective Global Assessment grade C and diabetic status predicted patient survival with UF the next most significant variable (risk ratio, 0.5/L per d; P ϭ 0.097). Baseline Ccrea, time-averaged Ccrea, and baseline D/P had no effect on patient or technique survival. This study shows that anuric patients can successfully use APD. Baseline UF, not Ccrea or membrane permeability, is associated with patient survival.

show abstract

Section: Discussioncontrasting

confidence: 63%

supporting

confidence: 82%

Survival of Functionally Anuric Patients on Automated Peritoneal Dialysis

Brown¹,

Davies²,

Rutherford³

et al. 2003

Journal of the American Society of Nephrology

347

311

View full text Add to dashboard Cite

show abstract

“…Our PD population was censored in 1998, at which time a survival analysis and description of longitudinal membrane function were published (16). Since 1998, increasing proportions of patients were treated with automated PD (APD), particularly when anuric, as described in the European Automated Peritoneal Dialysis Outcome Study (EAPOS) (9).…”

Section: Study Design and Patient Populationmentioning

confidence: 99%

“…Here we determined the association between patient survival and both solute transport and Pcl, measured and calculated independently, in a prospective, single-center cohort that had previously reported worse outcomes in patients with fPTS (16). We explored the relationship among peritoneal protein leak, comorbidity, and BP.…”

mentioning

confidence: 99%

Peritoneal Protein Clearance and not Peritoneal Membrane Transport Status Predicts Survival in a Contemporary Cohort of Peritoneal Dialysis Patients

Perl¹,

Huckvale²,

Chellar³

et al. 2009

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Background and objectives: Fast peritoneal membrane transport status may be due to inflammation or increased peritoneal membrane surface area. We evaluated the ability of peritoneal protein clearance (Pcl) to distinguish fast peritoneal membrane transport status as a consequence of peritoneal membrane inflammation and assess its impact on patient survival.Design, setting, participants, & measurements: Patients who initiated peritoneal dialysis at our center since January 1998 and had a baseline peritoneal equilibration test, measurement of dialysis adequacy, and 24-h dialysate Pcl were included. Demography, comorbidities, and biochemical data were prospectively collected. Follow-up was until death or the end of the period studied. Multivariate regression analysis identified factors that were associated with Pcl. A Cox proportional hazards model was used to identify factors that were associated with survival.Results: A total of 192 patients (56% men, mean age 54.3 ؎ 15.3; 32% with diabetes) were included. On univariate analysis, Pcl was negatively correlated with serum albumin and positively correlated with age, dialysate/plasma creatinine ratio (D/Pcr), the presence of peripheral vascular disease, and urine volume. On multivariate analysis, serum albumin, D/Pcr, urine volume, and peripheral vascular disease remained significant. Predictors of mortality were age, comorbidity grade, and Pcl but not D/Pcr.Conclusions: In this cohort, peritoneal transport status no longer predicted survival, whereas Pcl remained a predictor. Increased large-pore protein loss may reflect the severity of underlying cardiovascular disease, portending a poor prognosis for these patients.

show abstract

“…Unfortunately, PD treatment frequently results in progressive decline of ultrafiltration capacity of the peritoneum usually associated with histological changes and loss of peritoneal integrity (Davies et al 1998). Pathological changes in the peritoneum are mainly the result of the toxic properties of standard low pH PD fluids (PDF) containing high levels of the osmotic agent glucose and its degradation products (GDP) (Leung et al 2005;Amore et al 2003).…”

Section: Introductionmentioning

confidence: 99%

GSK-3β inhibition protects mesothelial cells during experimental peritoneal dialysis through upregulation of the heat shock response

Rusai

Kuster

Kratochwill

et al. 2013

Cell Stress and Chaperones

View full text Add to dashboard Cite

Peritoneal solute transport predicts survival on CAPD independently of residual renal function

Abstract: There is good reason to believe that high peritoneal solute transport is an independent marker of poor outcome in CAPD patients.

Cited by 197 publications

References 1 publication

Survival of Functionally Anuric Patients on Automated Peritoneal Dialysis

Survival of Functionally Anuric Patients on Automated Peritoneal Dialysis

Peritoneal Protein Clearance and not Peritoneal Membrane Transport Status Predicts Survival in a Contemporary Cohort of Peritoneal Dialysis Patients

GSK-3β inhibition protects mesothelial cells during experimental peritoneal dialysis through upregulation of the heat shock response

Contact Info

Product

Resources

About