High peritoneal transport status is not an independent risk factor for high mortality in patients treated with automated peritoneal dialysis.
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.
Chang
Tae Ik
TI
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Park
Jung Tak
JT
Lee
Dong Hyung
DH
Lee
Ju Hyun
JH
Yoo
Tae Hyun
TH
Kim
Beom Seok
BS
Kang
Shin-Wook
SW
Lee
Ho Yung
HY
Choi
Kyu Hun
KH
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
D015314:Dialysis Solutions; D005936:Glucans; D012709:Serum Albumin; D000077607:Icodextrin; D005947:Glucose
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