title: The importance of residual renal function in peritoneal dialysis.
abstract: BACKGROUND
  Peritoneal dialysis (PD) patients with preserved residual diuresis have a lower risk of death and complications. Here we analyzed associations between residual diuresis and presence of fluid overload and biomarkers of cardiac strain and nutrition in PD patients.
  
  
  METHODS
  Among 44 PD patients placed into three subgroups, depending on volume of residual diuresis (group A ≤ 500; group B 600-1900; and group C ≥ 2000 mL/day), we examined: overhydration (OH) assessed by bioimpedance analysis (BIA; yielding OH index OHBIA) and by clinical criteria (edema and hypertension); nutritional status (by subjective global assessment, SGA); metabolic status (electrolytes, serum lipid profile, CRP, and albumin); biomarkers of fluid overload and cardiac strain (N-terminal probrain natriuretic peptide, NT-proBNP, and troponin T, TnT); and, echocardiography and chest X-ray.
  
  
  RESULTS
  With increasing residual diuresis in group A, B and C, fewer patients had signs of overhydration defined as OHBIA > 1.1 L (75.0, 42.9 and 33.3 %) or peripheral edema (25.0, 21.4 and 0 %) and NT-proBNP (15199 ± 16150 vs. 5930 ± 9256 vs. 2600 ± 3907 pg/mL; p < 0.05) and TnT (0.15 ± 0.17 vs. 0.07 ± 0.09 vs. 0.04 ± 0.03 ng/mL; p < 0.05) were significantly lower. Significant differences were found also in ejection fraction, SGA, and total cholesterol, albumin and hemoglobin levels whereas blood pressures and serum CRP did not differ significantly.
  
  
  CONCLUSIONS
  Signs of OH and cardiac strain are common in PD patients, even in those with diuresis of 1000-2000 mL/day and with no clinical signs or symptoms, suggesting that even moderate decrease in residual renal function in PD patients associate with OH and other complications.
authors.affiliation: Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, 49 Przybyszewskiego Str, 60-355, Poznan, Poland.|Department of Pathophysiology, Poznan University of Medical Sciences, Poznan, Poland.|Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Dorota
authors.initials: D
authors.lastname: Sikorska
authors.affiliation: Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, 49 Przybyszewskiego Str, 60-355, Poznan, Poland. kpawlac@ump.edu.pl.|Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden. kpawlac@ump.edu.pl.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Pawlaczyk
authors.affiliation: Department of Rheumatology and Clinical Immunology, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Olewicz-Gawlik
authors.affiliation: Department of Pathophysiology, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Natasza
authors.initials: N
authors.lastname: Czepulis
authors.affiliation: Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, 49 Przybyszewskiego Str, 60-355, Poznan, Poland.
authors.forename: Bartlomiej
authors.initials: B
authors.lastname: Posnik
authors.affiliation: Department of Pathophysiology, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Baum
authors.affiliation: Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, 49 Przybyszewskiego Str, 60-355, Poznan, Poland.
authors.forename: Maria
authors.initials: M
authors.lastname: Wanic-Kossowska
authors.affiliation: Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Lindholm
authors.affiliation: Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, 49 Przybyszewskiego Str, 60-355, Poznan, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Oko
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D007677:Kidney Function Tests / Q000379:methods; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000379:methods; D011044:Poland; D065667:Renal Elimination; D012307:Risk Factors; D013223:Statistics as Topic; D014883:Water-Electrolyte Imbalance / Q000097:blood / Q000175:diagnosis / Q000209:etiology
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Bioimpedance; Cardiovascular risk; Hydration status; Peritoneal dialysis; Residual diuresis