Report from the 1995 Core Indicators for Peritoneal Dialysis Study Group.
The 1995 Peritoneal Dialysis Core Indicators Study was conducted by the Health Care Financing Administration to ascertain standard practices and outcomes in chronic peritoneal dialysis patients. Data from 1,202 patients who did not receive hemodialysis but who were on chronic ambulatory peritoneal dialysis (CAPD) for at least part of the 6-month period between November 1, 1994, and April 30, 1995, are reported. The mean serum albumin level for this cohort was 3.5 g/dL by the bromcresol green method and 3.2 g/dL by the bromcresol purple method. Data sufficient to calculate a weekly Kt/V(urea) or weekly creatinine clearance were available for only 34% of patient submissions. In these patients, the median weekly Kt/V(urea) was 1.7 using a fixed value for V of 0.58 x body weight and was 2.0 using the Watson equation to calculate V; the median weekly creatinine clearance was 60.7 L/wk/1.73 m2. The mean hematocrit for this cohort was 32% and the average weekly recombinant human erythropoietin (rHmEPO) dose was 115 u/kg. Hematocrit values < or = 30% were found in 50% of black patients and 31% of white patients. The average blood pressure among peritoneal dialysis patients was 139/80 mm Hg, with 29% of patients having a systolic blood pressure exceeding 150 mm Hg and 18% a diastolic blood pressure greater than 90 mm Hg. In summary, serum albumin levels were significantly lower in peritoneal dialysis patients than in hemodialysis patients. Approximately one third of peritoneal dialysis patients did not have an adequacy measure obtained during the 6-month observation period. A significant minority of patients had either inadequately treated anemia of chronic renal disease or hypertension. There is an opportunity to substantially improve the medical care provided to chronic peritoneal dialysis patients.
Rocco
M V
MV
Department of Internal Medicine, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27157-1053, USA. mrocco@bgsm.edu
Flanigan
M J
MJ
Beaver
S
S
Frederick
P
P
Gentile
D E
DE
McClellan
W M
WM
Polder
J
J
Prowant
B F
BF
Taylor
L
L
Helgerson
S D
SD
D000293:Adolescent; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001835:Body Weight; D015331:Cohort Studies; D003404:Creatinine / Q000378:metabolism; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D006400:Hematocrit; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011994:Recombinant Proteins; D006435:Renal Dialysis; D012709:Serum Albumin / Q000032:analysis; D014508:Urea / Q000378:metabolism
D011994:Recombinant Proteins; D012709:Serum Albumin; D004921:Erythropoietin; D014508:Urea; D003404:Creatinine