title: Inflammation and myocardial damage markers influence loss of residual renal function in peritoneal dialysis patients.
abstract: BACKGROUND
  Residual renal function (RRF) has been identified as the most important component in dialysis adequacy and has a strong effect on clinical outcomes. This justifies any effort in understanding the mechanism behind the preservation or decline in RRF. The aim of this study was to analyze the possible association of components of cardio-renal syndrome with the rate of decline in RRF.
  
  
  METHODS
  A retrospective cohort study was performed in a group of prevalent adult patients on continuous ambulatory peritoneal dialysis (CAPD). Patients were analyzed at baseline and after a 30-month follow-up. Evaluations included measurements of residual renal function, dialysis adequacy parameters, cardiovascular comorbidity, and measurements of biochemical markers of cardiovascular disease (CVD) and inflammation, as well as resting electrocardiography.
  
  
  RESULTS
  We included 129 patients in the study who were divided into groups according to loss of RRF, considering the cut-off point as 100 mL/day of 24 h urine volume. At baseline, there were no differences between groups: patients who lost RRF showed low values of 24 h urine volume, higher levels of systolic blood pressure, N-terminal pro-brain natriuretic peptide (NT-proBNP), C-reactive protein (CRP), IL-6, and low values of serum albumin. In the multivariate analysis, age, albumin, CRP, and NT-proBNP were significant risk factors for the loss of RRF.
  
  
  CONCLUSIONS
  Data indicate a close relationship between heart and kidney function where chronic kidney disease (CKD) affects and is an effect of, heart function, indicative of a bi-directional influence that leads to a vicious cycle, promoting deleterious effects on both systems.
authors.affiliation: Unidad de Investigación Médica en Enfermedades Nefrológicas, UMAE Hospital de Especialidades "Dr. Bernardo Sepúlveda Gutiérrez", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F., México. Electronic address: silvia-palomo@hotmail.com.
authors.forename: Silvia
authors.initials: S
authors.lastname: Palomo-Piñón
authors.affiliation: Unidad de Investigación Médica en Enfermedades Nefrológicas, UMAE Hospital de Especialidades "Dr. Bernardo Sepúlveda Gutiérrez", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F., México.
authors.forename: Carmen Josefina
authors.initials: CJ
authors.lastname: Mora-Villalpando
authors.affiliation: Unidad de Investigación Médica en Enfermedades Nefrológicas, UMAE Hospital de Especialidades "Dr. Bernardo Sepúlveda Gutiérrez", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F., México.
authors.forename: Ma
authors.initials: M
authors.lastname: Del Carmen Prado-Uribe
authors.affiliation: Instituto Politécnico Nacional, Escuela Superior de Medicina, Sección de Estudios de Posgrado e Investigación, México, D.F., México.
authors.forename: Guillermo Manuel
authors.initials: GM
authors.lastname: Ceballos-Reyes
authors.affiliation: Unidad de Investigación Médica en Enfermedades Nefrológicas, UMAE Hospital de Especialidades "Dr. Bernardo Sepúlveda Gutiérrez", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F., México.
authors.forename: Ma
authors.initials: M
authors.lastname: De Jesús Ventura-García
authors.affiliation: Unidad de Investigación Médica en Enfermedades Nefrológicas, UMAE Hospital de Especialidades "Dr. Bernardo Sepúlveda Gutiérrez", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F., México.
authors.forename: Marcela
authors.initials: M
authors.lastname: Ávila-Díaz
authors.affiliation: Departamento de Cardiología, UMAE Hospital de Especialidades "Dr. Bernardo Sepúlveda Gutiérrez", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F., México.
authors.forename: Oscar Orihuela
authors.initials: OO
authors.lastname: Rodríguez
authors.affiliation: Unidad de Investigación Médica en Enfermedades Nefrológicas, UMAE Hospital de Especialidades "Dr. Bernardo Sepúlveda Gutiérrez", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F., México.
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Paniagua-Sierra
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D059347:Cardio-Renal Syndrome / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000503:physiopathology* / Q000628:therapy; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D015415:Biomarkers
keywords: Cardiorenal syndromes; Inflammation; Myocardial damage; Peritoneal dialysis; Residual renal function