title: [Faster decline of total fluid removal is an independent risk factor for increased motality in patients on peritoneal dialysis].
abstract: OBJECTIVE
  To explore the relationship between the rate of decline of total fluid removal (TFR), the sum  of 24-hour urine and ultrafiltration and all-cause mortality in patients undergoing peritoneal dialysis (PD)  through a prospective cohort study.
  
  
  METHODS
  The study included 297 incident patients, starting PD between July  2002 and February 2007. All the patients were followed up until death, transfering to hemodialysis, or kidney  transplant by February 2008. Demographics, biochemical data and dialysis adequacy were collected at the baseline.  The TFR, urine and ultrafiltration before each clinic day were averaged every 3 months throughout the follow-up.  The slope of TFR (k-TFR) was calculated for each patient over time by a simple linear regression analysis.
  
  
  RESULTS
  The median age was 62 years, and 42.4% of the 297 incident PD patients were male and 71 patients (23.9%)  died during the median 30-month follow-up. By multivariate Cox regression analysis, k-TFR rather than the  baseline TFR was a significant risk factor of mortality after being adjusted for age, presence of diabetes  mellitus, baseline hemoglobin and serum albumin. In another multivariate model including all the above  covariates, k-TFR was superior to the baseline TFR for prediction of mortality.
  
  
  CONCLUSIONS
  Faster decline of  total fluid removal is significantly associated with higher risk of all-cause mortality.
authors.affiliation: Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of  Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China, Beijing 100034, China.
authors.forename: Zhi-Kai
authors.initials: ZK
authors.lastname: Yang
authors.forename: Jie
authors.initials: J
authors.lastname: Dong
authors.forename: Li
authors.initials: L
authors.lastname: Zuo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001826:Body Fluids / Q000378:metabolism*; D015314:Dialysis Solutions / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000401:mortality*; D010537:Peritoneum / Q000378:metabolism*; D011446:Prospective Studies; D012307:Risk Factors; D014882:Water-Electrolyte Balance / Q000502:physiology; D055815:Young Adult
chemical_list: D015314:Dialysis Solutions