Relationship between Kt/V urea-based dialysis adequacy and nutritional status and their effect on the components of the quality of life in incident peritoneal dialysis patients.
BACKGROUND
It is well known that the quality of life of patients with chronic kidney disease can be improved by dialysis. While previous studies have used retrospective designs and adhered to a standard target prescribed by clinical guidelines, our study prospectively investigates the association between the adequacy of peritoneal dialysis (PD) and measures of nutritional status on quality-of-life domains in a cohort of incident PD patients.


METHODS
It was a prospective 6-month observational study. Eighty incident PD participants who were treated in a hospital-based PD center were enrolled. The period of enrollment was January 2009-June 2010; follow-up continued until December 2010. PD adequacy indices, including Kt/V urea, weekly Ccr (WCcr), measures of nutritional status (albumin, BMI), and nPCR were measured at 1 month and 6 months after PD initiation. SF-36 health survey questionnaires were used to measure the quality of life. The outcomes were used to measure the changes in the domains of the SF-36 after 6 months of PD therapy.


RESULTS
Seventy-seven incident patients who underwent PD for 6 months were included in the study. The mean age was 47.3 years, and the male-to-female ratio was 38:39. A peritoneal Kt/V urea value of 1.2, which was also the baseline cutoff value, was found to have the highest influence on SF-36 domains. Patients with baseline peritoneal Kt/V urea value of <1.2 showed improvement in the physical functioning and role limitation of physical functioning components after 6 months of PD. In contrast, patients with baseline peritoneal Kt/V urea values of ≥1.2 showed remarkable improvement in the general health, physical functioning, role limitation caused by physical problems, and bodily pain components. However, the trend of improvement decreased in patients with baseline nPCR of <1.2. Baseline renal WCcr did not influence the improvement in the SF-36 domains.


CONCLUSIONS
A small cohort and a short observation period.


CONCLUSIONS
The baseline level of peritoneal Kt/V urea affected the components of the quality of life after PD initiation. In contrast, a lower baseline nPCR level was associated with deterioration in the quality of life after PD therapy.
Division of Nephrology, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Jin-Bor
JB
Chen
King-Kwan
KK
Lam
Yu-Jen
YJ
Su
Wen-Chin
WC
Lee
Ben-Chung
BC
Cheng
Chien-Chun
CC
Kuo
Chien-Hsing
CH
Wu
Eton
E
Lin
Yi-Chun
YC
Wang
Te-Chuan
TC
Chen
Shang-Chih
SC
Liao
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000502:physiology*; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000379:methods; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D014508:Urea / Q000097:blood*; D055815:Young Adult
D015415:Biomarkers; D014508:Urea