title: Influence of peritoneal transport characteristics on nutritional status and clinical outcome in Chinese diabetic nephropathy patients on peritoneal dialysis.
abstract: BACKGROUND
  High peritoneal transport status was previously thought to be a poor prognostic factor in peritoneal dialysis (PD) patients. However, its effect on diabetic nephropathy PD patients is unclear in consideration of the adverse impact of diabetes itself. The purpose of this study was to investigate the influence of peritoneal transport characteristics on nutritional status and clinical outcome in diabetic nephropathy patients on PD.
  
  
  METHODS
  One hundred and two diabetic nephropathy patients on PD were enrolled in this observational cohort study. According to the initial peritoneal equilibration test result, patients were divided into two groups: Higher transport group (HT, including high and high average transport) and lower transport group (LT, including low and low-average transport). Demographic characteristics, biochemical data, dialysis adequacy, and nutritional status were evaluated. Clinical outcomes were compared. Risk factors for death-censored technique failure and mortality were analyzed.
  
  
  RESULTS
  Compared with LT group (n = 37), serum albumin was significantly lower and the incidence of malnutrition by subjective global assessment was significantly higher in HT group (n = 65) (P < 0.05). Kaplan-Meier analyses showed that death-censored technique failure and mortality were significantly increased in HT group compared with that in LT group. On multivariate Cox analyses, higher peritoneal transport status and lower residual renal function (RRF) were independent predictors of death-censored technique failure when adjusted for serum albumin and total weekly urea clearance (Kt/V). Independent predictors of mortality were advanced age, anemia, hypoalbuminemia, and lower RRF, but not higher peritoneal transport status.
  
  
  CONCLUSIONS
  Higher peritoneal transport status has an adverse influence on nutrition for diabetic nephropathy patients on PD. Higher peritoneal transport status is a significant independent risk factor for death-censored technique failure, but not for mortality in diabetic nephropathy patients on PD.
authors.forename: Ji-Chao
authors.initials: JC
authors.lastname: Guan
authors.forename: Wei
authors.initials: W
authors.lastname: Bian
authors.forename: Xiao-Hui
authors.initials: XH
authors.lastname: Zhang
authors.affiliation: Kidney Disease Center, First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310003, China.
authors.forename: Zhang-Fei
authors.initials: ZF
authors.lastname: Shou
authors.forename: Jiang-Hua
authors.initials: JH
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001692:Biological Transport; D015331:Cohort Studies; D003928:Diabetic Nephropathies / Q000378:metabolism* / Q000628:therapy*; D005260:Female; D006801:Humans; D007668:Kidney / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010530:Peritoneal Dialysis
references.citation: Clin Nephrol. 2010 Nov;74 Suppl 1:S20-2
references.pmid: 20979958
references.citation: Ren Fail. 2010;32(7):788-95
references.pmid: 20662691
references.citation: Am J Kidney Dis. 2011 Sep;58(3):418-28
references.pmid: 21601335
references.citation: J Med Assoc Thai. 2011 Sep;94 Suppl 4:S94-100
references.pmid: 22043574
references.citation: Sichuan Da Xue Xue Bao Yi Xue Ban. 2012 May;43(3):442-6
references.pmid: 22812255
references.citation: Diabetes Res Clin Pract. 2013 Jun;100(3):354-61
references.pmid: 23608550
references.citation: JAMA. 2013 Sep 4;310(9):948-59
references.pmid: 24002281
references.citation: Clin Nephrol. 2013 Oct;80(4):270-9
references.pmid: 23816475
references.citation: Ren Fail. 2014 Mar;36(2):149-53
references.pmid: 24131086
references.citation: J Am Soc Nephrol. 2002 May;13(5):1307-20
references.pmid: 11961019
references.citation: J Am Soc Nephrol. 1996 Feb;7(2):198-207
references.pmid: 8785388
references.citation: J Am Soc Nephrol. 1996 May;7(5):745-50
references.pmid: 8738810
references.citation: J Am Soc Nephrol. 1998 Jul;9(7):1285-92
references.pmid: 9644640
references.citation: Int Urol Nephrol. 2005;37(3):575-9
references.pmid: 16307345
references.citation: J Am Soc Nephrol. 2006 Jan;17(1):271-8
references.pmid: 16306167
references.citation: J Am Soc Nephrol. 2006 Sep;17(9):2591-8
references.pmid: 16885406
references.citation: Perit Dial Int. 2008 Jan-Feb;28(1):82-92
references.pmid: 18178952
references.citation: J Am Soc Nephrol. 2007 Mar;18(3):896-903
references.pmid: 17267743
references.citation: Nephrol Dial Transplant. 2007 Jan;22(1):218-23
references.pmid: 17005522
references.citation: Semin Dial. 2008 Jan-Feb;21(1):7-10
references.pmid: 18251948
references.citation: Kidney Int Suppl. 2008 Apr;(108):S34-41
references.pmid: 18379545
references.citation: Ther Apher Dial. 2008 Dec;12(6):475-83
references.pmid: 19140846
references.citation: Clin J Am Soc Nephrol. 2009 Jul;4(7):1201-6
references.pmid: 19478100
references.citation: J Ren Nutr. 2011 Mar;21(2):176-83
references.pmid: 21193323