Outcome for continuous ambulatory peritoneal dialysis patients is not predicted by peritoneal permeability characteristics.
For the present study, we investigated the peritoneal transport of fluid and solutes and the clinical outcomes of 44 continuous ambulatory peritoneal dialysis (CAPD) patients with various peritoneal transport characteristics. Based on 24-hour urine and dialysate collections and 4-hour dwell studies [peritoneal equilibration test (PET)], the patients were divided into two transport groups by dialysate-to-plasma ratio of creatinine at 240 minutes (D/PCr240). The groups consisted of 21 high transporters (D/P = 0.81; mean age: 63.9 +/- 8.2 years) and 23 patients of other transport types (D/P < 0.81; mean age: 67.1 +/- 7.3). Mean CAPD duration was 57.14 +/- 30.4 months and 39.14 +/- 30.4 months respectively (p = 0.07). Estimations were made of weight, body surface area (BSA), percent body water, plasma albumin (PA), Kt/Vurea, weekly creatinine clearance (TCCr), fluid removal, residual renal function, and normalized protein catabolic rate (nPCR). The results showed that high transporters had statistically significant, lower values for: (1) peritoneal fluid (p = 0.02); (2) estimated glomerular filtration rate (GFR: 0.5 +/- 0.77 mL/min vs 2.15 +/- 2.2 mL/min, p = 0.002); and (3) nPCR (0.66 +/- 0.16 g/kg/day vs 0.84 +/- 0.23 g/kg/day, p = 0.003). No statistically significant differences were observed with regard to the other parameters (BSA, PA, Kt/Vurea, TCCr). Cumulative survival rates at two and five years were 90% and 70% for all patients. No statistically significant difference was seen when comparing the survival curves of high transporters and patients of other transport types (p = 0.33, Cox's F-test). In conclusion, we saw no clear evidence that higher peritoneal permeability negatively influences clinical outcome. Other comorbid factors may be related in a more important way to the survival rate for CAPD patients.
Passadakis
P S
PS
Democritus University of Thrace, Division of Nephrology, G.D. Hospital of Alexandroupolis, Greece.
Thodis
E D
ED
Panagoutsos
S A
SA
Selisiou
C A
CA
Pitta
E M
EM
Vargemezis
V A
VA
D000368:Aged; D001692:Biological Transport; D001830:Body Surface Area; D001834:Body Water; D003404:Creatinine / Q000032:analysis; D003924:Diabetes Mellitus, Type 2; D003928:Diabetic Nephropathies / Q000503:physiopathology / Q000628:therapy; D015314:Dialysis Solutions / Q000737:chemistry; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000401:mortality; D010537:Peritoneum / Q000378:metabolism*; D010539:Permeability; D016016:Proportional Hazards Models; D012307:Risk Factors; D015996:Survival Rate
D015314:Dialysis Solutions; D003404:Creatinine