title: High peritoneal transport status is not an independent risk factor for high mortality in patients treated with automated peritoneal dialysis.
abstract: We undertook this study to elucidate whether baseline peritoneal membrane transport characteristics are associated with high mortality in incident automated peritoneal dialysis (APD) patients. This retrospective study includes 117 patients who started APD at Yonsei University Health System from 1996 to 2008 and had a PET within 3 months of APD initiation. High transporters were significantly older and had a higher incidence of cardiovascular disease. Patient survival for years 1, 3, and 5 were 85%, 64%, and 35% for high transporter and 94%, 81%, and 68% for non-high transporter group (P<0.01). Multivariate analysis revealed that age, diabetes, cardiovascular disease, serum albumin level, and residual renal function were independently associated with high mortality in APD patients. In contrast, high transport status was not a significant predictor for mortality in this population when the other covariates were included. Even though high transport was significantly associated with mortality in the univariate analysis, its role seemed to be influenced by other comorbid conditions. These findings suggest that the proper management of these comorbid conditions, as well as appropriate ultrafiltration by use of APD and/or icodextrin, must be considered as protective strategies to improve survival in peritoneal dialysis patients with high transport.
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Tae Ik
authors.initials: TI
authors.lastname: Chang
authors.forename: Jung Tak
authors.initials: JT
authors.lastname: Park
authors.forename: Dong Hyung
authors.initials: DH
authors.lastname: Lee
authors.forename: Ju Hyun
authors.initials: JH
authors.lastname: Lee
authors.forename: Tae Hyun
authors.initials: TH
authors.lastname: Yoo
authors.forename: Beom Seok
authors.initials: BS
authors.lastname: Kim
authors.forename: Shin-Wook
authors.initials: SW
authors.lastname: Kang
authors.forename: Ho Yung
authors.initials: HY
authors.lastname: Lee
authors.forename: Kyu Hun
authors.initials: KH
authors.lastname: Choi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001331:Automation; D002318:Cardiovascular Diseases / Q000150:complications; D048909:Diabetes Complications; D015314:Dialysis Solutions / Q000627:therapeutic use; D005260:Female; D005919:Glomerular Filtration Rate; D005936:Glucans / Q000627:therapeutic use; D005947:Glucose / Q000627:therapeutic use; D006801:Humans; D000077607:Icodextrin; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010530:Peritoneal Dialysis / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D015996:Survival Rate
chemical_list: D015314:Dialysis Solutions; D005936:Glucans; D012709:Serum Albumin; D000077607:Icodextrin; D005947:Glucose
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