The Predictive Value of Kt/V and Peritoneal Solute Transport in Capd Patients is Dependent on the Type of Comorbidity Present

Abstract

Comorbidity, age, dialysis dose (KT/Vurea)’ plasma albumin, and peritoneal function (DIP treat) were measured cross-sectionally in 228 continuous ambulatory peritoneal dialysis (CAPD) patients, who were then followed up for a mean of two years. Comorbidity, utilizing a semiquantitative score described previously, was the most powerful predictor of mortality in both univariate and multivariate analysis. Using univariate analysis, all the variables predicted outcome with statistical significance, mortality being associated with lower KT/V and plasma albumin and a higher DIP treat On multivariate analysis only comorbidity, age, and KT/V remained independent predictors. Data was further analyzed on the basis of type of comorbid condition. In those patients without comorbid disease (n = 127) neither KT/V, albumin nor DIP retreamendicted outcome. In patients with clinical evidence of ischemic heart disease the KT/V was a significant predictor of favorable outcome. In those with clinical evidence of left ventricular function, mortality was significantly and independently associated with low plasma albumin, high DIP treat’ and KT/V. It is suggested that the concept of treatment adequacy in CAPD patients must include both measures of dialysis dose and peritoneal function, particularly in the context of the patient's comorbidity.

Health‐related Quality of Life in Patients on Peritoneal Dialysis in Serbia: Comparison with Hemodialysis

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Quantifying comorbidity in peritoneal dialysis patients and its relationship to other predictors of survival

“…ECG and echocardiograms. The approach to identification of significant comorbid disease has been described previously, where it has been shown to predict patient survival in cross-sectional analyses [9,10]. Certain general principles apply.…”

“…A simple index of comorbid conditions was developed at that time for this study, as none other was then available. It enables patients to be graded according to their comorbid load: 0 (low risk), 1-2 comorbidities (medium risk), and 3 or more (high risk) [9,10]. Seven separate comorbid domains were identified, selected to reflect the high prevalence of cardiovascular disease in the end-stage renal failure population.…”

Peritoneal function in clinical practice: the importance of follow-up and its measurement in patients. Recommendations for patient information and measurement of peritoneal function

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