Does association with volume status and inflammation account for the increased death risk from high peritoneal protein clearance in peritoneal dialysis?
OBJECTIVE
To determine if the association between high peritoneal protein clearance (PrC) and increased all-cause mortality is explained by inflammation and volume overload in continuous ambulatory peritoneal dialysis patients.


METHODS
A total of 216 incident patients were enrolled. Demographics, biochemistry, inflammatory and volume status, peritoneal transport rate, fluid and solute removal were collected at baseline.


RESULTS
The median PrC was 57.2 ml/day. A high PrC was associated with more severe inflammation and volume overload. Using a multivariate regression model, for every 1-ml/day increase in PrC, the adjusted HR was 1.06 (1.00-1.12; p = 0.046) for all-cause death adjusted for age, diabetes, hemoglobin and D/Pcr. The predictability of PrC for all-cause death remained the same or mildly changed after additionally adjusted for inflammatory and volume overload markers with HR of 1.07 (1.00-1.14; p = 0.043) and 1.05 (0.99-1.12; p = 0.08), respectively.


CONCLUSIONS
Peritoneal PrC, although correlated with volume overload and inflammation, is largely an independent predictor of mortality.
Dong
Jie
J
Renal Division, Department of Medicine, Peking University First Hospital and Institute of Nephrology, Peking University, and Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, PR China. dongjie@medmail.com.cn
Xu
Ying
Y
Li
Yanjun
Y
Yang
Zhikai
Z
D000368:Aged; D002423:Cause of Death; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects / Q000401:mortality*; D010537:Peritoneum; D011379:Prognosis; D011506:Proteins; D015996:Survival Rate
D011506:Proteins