title: The impact of strict volume control strategy on patient survival and technique failure in peritoneal dialysis patients.
abstract: Strict volume control strategy provides better cardiac functions and control of hypertension in dialysis patients. We investigated the effect of this strategy on mortality and technique failure in peritoneal dialysis patients over a 10-year period. 243 patients were enrolled. Strict volume control by dietary salt restriction and ultrafiltration was applied. Mean systolic and diastolic blood pressures decreased from 138.4 ± 29.9 and 86.3 ± 16.8 to 114.9 ± 32.3 and 74.7 ± 18.3 mm Hg, respectively. Overall and cardiovascular mortality rates were 48.4 and 29.6 per 1,000 patient-years, respectively. In multivariate analysis, age, diabetes and baseline serum albumin level were independent predictors of overall mortality, and age, diabetes and baseline serum calcium of cardiovascular mortality. Residual diuresis and peritoneal equilibration test values were not related to mortality. Strict volume control leads to lower mortality than comparable series in the literature. Technique survival is better during the first 3 years, but not after 5 years.
authors.affiliation: Division of Nephrology, School of Medicine, Ege University, Izmir, Turkey. fatihkircelli@yahoo.com
authors.forename: Fatih
authors.initials: F
authors.lastname: Kircelli
authors.forename: Gulay
authors.initials: G
authors.lastname: Asci
authors.forename: Mumtaz
authors.initials: M
authors.lastname: Yilmaz
authors.forename: Ebru
authors.initials: E
authors.lastname: Sevinc Ok
authors.forename: Meltem Sezis
authors.initials: MS
authors.lastname: Demirci
authors.forename: Huseyin
authors.initials: H
authors.lastname: Toz
authors.forename: Fehmi
authors.initials: F
authors.lastname: Akcicek
authors.forename: Ercan
authors.initials: E
authors.lastname: Ok
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ozkahya
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D002908:Chronic Disease; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology; D004039:Diet, Sodium-Restricted; D005260:Female; D005921:Glomerulonephritis / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010045:Outpatients; D010530:Peritoneal Dialysis / Q000379:methods / Q000401:mortality; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D016019:Survival Analysis; D017211:Treatment Failure
chemical_list: D001786:Blood Glucose; D012709:Serum Albumin