Peritoneal protein transport during the baseline peritoneal equilibration test is an accurate predictor of the outcome of peritoneal dialysis patients.
BACKGROUND
Peritoneal protein excretion (PPE) is a potential marker of the outcome in peritoneal dialysis (PD) patients.


METHODS
Observational study of a cohort of 269 patients starting PD in a single unit.


METHODS
total PPE during a baseline peritoneal equilibration test (PET; PET-PPE) and 24-hour PPE. Control variables: essential baseline demographic, laboratory and adequacy markers.


RESULTS
mortality, cardiovascular events and risk of peritonitis. We applied univariate and multivariate strategies of survival analysis.


RESULTS
PET-PPE sustained a significant, yet limited correlation with 24-hour PPE (r = 0.46, p < 0.0005). At baseline, the main study variables showed an independent correlation with peritoneal transport characteristics (D/P(240') creatinine) and cardiovascular comorbidity. PET-PPE (p < 0.0005, model global χ(2) 59.4) was a more accurate predictor of overall mortality than 24-hour PPE (p = 0.04, χ(2) 50.5). Moreover, PPE during PET, but not 24-hour PPE, was an independent predictor of the risks of cardiovascular and infectious mortality, and of peritonitis.


CONCLUSIONS
Baseline PPE represents a strong independent marker of survival of PD patients. Estimation of PPE during PET is more accurate than 24-hour PPE for this purpose, sustains a definite independent association with cardiovascular and infectious mortality, and shows a significant correlation with the risk of peritonitis.
Pérez-Fontán
Miguel
M
Division of Nephrology, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain. Miguel.Perez.Fontan@sergas.es
Rodríguez-Carmona
Ana
A
Barreda
Dolores
D
López-Muñiz
Andrés
A
Blanco-Castro
Natalia
N
García-Falcón
Teresa
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism; D002648:Child; D015331:Cohort Studies; D003955:Diagnostic Tests, Routine / Q000379:methods / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects; D010537:Peritoneum / Q000378:metabolism*; D010538:Peritonitis / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism; D011237:Predictive Value of Tests; D021381:Protein Transport / Q000502:physiology; D016896:Treatment Outcome; D055815:Young Adult
D015415:Biomarkers