Reduced residual renal function is a risk of peritonitis in continuous ambulatory peritoneal dialysis patients

SeungHyeok Han, Sang Choel Lee, Songvogue Ahn, Jung Eun Lee, Dong Ki Kim, Tae Hee Lee, Sung Jin Moon, Beom Seok Kim, Shin-Wook Kang, Kyu Hun Choi, Ho Yung Lee, Dae Suk Han

Research output: Contribution to journalArticle

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Abstract

Background. Loss of residual renal function (RRF) contributes to anaemia, inflammation and malnutrition and is also a strong predictor of mortality in continuous ambulatory peritoneal dialysis (CAPD) patients. However, the role of RRF on peritonitis is not yet clearly established. This study aimed to evaluate the effect of RRF on the development of peritonitis. Methods. Study subjects were 204 end-stage renal disease (ESRD) patients who started PD from January 2000 to December 2005. Biochemical and clinical data within 1 month of PD commencement were considered as baseline. To determine risk factors for peritonitis, multivariate Cox regression was performed. Kaplan-Meier analysis and log-rank test were used to examine the difference of peritonitis-free period according to the presence of diabetes and RRF. Results. On univariate analysis basedon baseline data in first peritonitis, diabetes was less prevalent and RRF (6.7 ± 2.6 vs 4.0 ± 2.3 ml/min/1.73 m2, P < 0.01), haemoglobin (10.9 ± 1.2 vs 10.6 ± 1.2 g/dl, P < 0.05) and serum albumin level (3.6 ± 0.4 vs 3.4 ± 0.4 g/dl, P < 0.01) were significantly higher in the peritonitis-free group. Kaplan-Meier analysis showed that time to first PD peritonitis episode was significantly longer in the non-diabetic patients (P < 0.001) and in patients with higher residual GFR (P < 0.001). Multivariate analysis showed that diabetes [hazard ratio(HR) 1.64, P < 0.05] and RRF (per 1 ml/min/1.73 m2 increase, HR 0.81, P < 0.01) were independent risk factors. Conclusion. Our study revealed that RRF and diabetes were risk factors for peritonitis. These results suggest that preservation of RRF should be viewed as a protective strategy to reduce peritonitis.

Original languageEnglish
Pages (from-to)2653-2658
Number of pages6
JournalNephrology Dialysis Transplantation
Volume22
Issue number9
DOIs
Publication statusPublished - 2007 Sep 1

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Continuous Ambulatory Peritoneal Dialysis
Peritonitis
Kidney
Kaplan-Meier Estimate
Serum Albumin
Malnutrition
Chronic Kidney Failure
Anemia
Hemoglobins
Multivariate Analysis
Inflammation
Mortality

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Transplantation

Cite this

Han, SeungHyeok ; Lee, Sang Choel ; Ahn, Songvogue ; Lee, Jung Eun ; Kim, Dong Ki ; Lee, Tae Hee ; Moon, Sung Jin ; Kim, Beom Seok ; Kang, Shin-Wook ; Choi, Kyu Hun ; Lee, Ho Yung ; Han, Dae Suk. / Reduced residual renal function is a risk of peritonitis in continuous ambulatory peritoneal dialysis patients. In: Nephrology Dialysis Transplantation. 2007 ; Vol. 22, No. 9. pp. 2653-2658.
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abstract = "Background. Loss of residual renal function (RRF) contributes to anaemia, inflammation and malnutrition and is also a strong predictor of mortality in continuous ambulatory peritoneal dialysis (CAPD) patients. However, the role of RRF on peritonitis is not yet clearly established. This study aimed to evaluate the effect of RRF on the development of peritonitis. Methods. Study subjects were 204 end-stage renal disease (ESRD) patients who started PD from January 2000 to December 2005. Biochemical and clinical data within 1 month of PD commencement were considered as baseline. To determine risk factors for peritonitis, multivariate Cox regression was performed. Kaplan-Meier analysis and log-rank test were used to examine the difference of peritonitis-free period according to the presence of diabetes and RRF. Results. On univariate analysis basedon baseline data in first peritonitis, diabetes was less prevalent and RRF (6.7 ± 2.6 vs 4.0 ± 2.3 ml/min/1.73 m2, P < 0.01), haemoglobin (10.9 ± 1.2 vs 10.6 ± 1.2 g/dl, P < 0.05) and serum albumin level (3.6 ± 0.4 vs 3.4 ± 0.4 g/dl, P < 0.01) were significantly higher in the peritonitis-free group. Kaplan-Meier analysis showed that time to first PD peritonitis episode was significantly longer in the non-diabetic patients (P < 0.001) and in patients with higher residual GFR (P < 0.001). Multivariate analysis showed that diabetes [hazard ratio(HR) 1.64, P < 0.05] and RRF (per 1 ml/min/1.73 m2 increase, HR 0.81, P < 0.01) were independent risk factors. Conclusion. Our study revealed that RRF and diabetes were risk factors for peritonitis. These results suggest that preservation of RRF should be viewed as a protective strategy to reduce peritonitis.",
author = "SeungHyeok Han and Lee, {Sang Choel} and Songvogue Ahn and Lee, {Jung Eun} and Kim, {Dong Ki} and Lee, {Tae Hee} and Moon, {Sung Jin} and Kim, {Beom Seok} and Shin-Wook Kang and Choi, {Kyu Hun} and Lee, {Ho Yung} and Han, {Dae Suk}",
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Reduced residual renal function is a risk of peritonitis in continuous ambulatory peritoneal dialysis patients. / Han, SeungHyeok; Lee, Sang Choel; Ahn, Songvogue; Lee, Jung Eun; Kim, Dong Ki; Lee, Tae Hee; Moon, Sung Jin; Kim, Beom Seok; Kang, Shin-Wook; Choi, Kyu Hun; Lee, Ho Yung; Han, Dae Suk.

In: Nephrology Dialysis Transplantation, Vol. 22, No. 9, 01.09.2007, p. 2653-2658.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Reduced residual renal function is a risk of peritonitis in continuous ambulatory peritoneal dialysis patients

AU - Han, SeungHyeok

AU - Lee, Sang Choel

AU - Ahn, Songvogue

AU - Lee, Jung Eun

AU - Kim, Dong Ki

AU - Lee, Tae Hee

AU - Moon, Sung Jin

AU - Kim, Beom Seok

AU - Kang, Shin-Wook

AU - Choi, Kyu Hun

AU - Lee, Ho Yung

AU - Han, Dae Suk

PY - 2007/9/1

Y1 - 2007/9/1

N2 - Background. Loss of residual renal function (RRF) contributes to anaemia, inflammation and malnutrition and is also a strong predictor of mortality in continuous ambulatory peritoneal dialysis (CAPD) patients. However, the role of RRF on peritonitis is not yet clearly established. This study aimed to evaluate the effect of RRF on the development of peritonitis. Methods. Study subjects were 204 end-stage renal disease (ESRD) patients who started PD from January 2000 to December 2005. Biochemical and clinical data within 1 month of PD commencement were considered as baseline. To determine risk factors for peritonitis, multivariate Cox regression was performed. Kaplan-Meier analysis and log-rank test were used to examine the difference of peritonitis-free period according to the presence of diabetes and RRF. Results. On univariate analysis basedon baseline data in first peritonitis, diabetes was less prevalent and RRF (6.7 ± 2.6 vs 4.0 ± 2.3 ml/min/1.73 m2, P < 0.01), haemoglobin (10.9 ± 1.2 vs 10.6 ± 1.2 g/dl, P < 0.05) and serum albumin level (3.6 ± 0.4 vs 3.4 ± 0.4 g/dl, P < 0.01) were significantly higher in the peritonitis-free group. Kaplan-Meier analysis showed that time to first PD peritonitis episode was significantly longer in the non-diabetic patients (P < 0.001) and in patients with higher residual GFR (P < 0.001). Multivariate analysis showed that diabetes [hazard ratio(HR) 1.64, P < 0.05] and RRF (per 1 ml/min/1.73 m2 increase, HR 0.81, P < 0.01) were independent risk factors. Conclusion. Our study revealed that RRF and diabetes were risk factors for peritonitis. These results suggest that preservation of RRF should be viewed as a protective strategy to reduce peritonitis.

AB - Background. Loss of residual renal function (RRF) contributes to anaemia, inflammation and malnutrition and is also a strong predictor of mortality in continuous ambulatory peritoneal dialysis (CAPD) patients. However, the role of RRF on peritonitis is not yet clearly established. This study aimed to evaluate the effect of RRF on the development of peritonitis. Methods. Study subjects were 204 end-stage renal disease (ESRD) patients who started PD from January 2000 to December 2005. Biochemical and clinical data within 1 month of PD commencement were considered as baseline. To determine risk factors for peritonitis, multivariate Cox regression was performed. Kaplan-Meier analysis and log-rank test were used to examine the difference of peritonitis-free period according to the presence of diabetes and RRF. Results. On univariate analysis basedon baseline data in first peritonitis, diabetes was less prevalent and RRF (6.7 ± 2.6 vs 4.0 ± 2.3 ml/min/1.73 m2, P < 0.01), haemoglobin (10.9 ± 1.2 vs 10.6 ± 1.2 g/dl, P < 0.05) and serum albumin level (3.6 ± 0.4 vs 3.4 ± 0.4 g/dl, P < 0.01) were significantly higher in the peritonitis-free group. Kaplan-Meier analysis showed that time to first PD peritonitis episode was significantly longer in the non-diabetic patients (P < 0.001) and in patients with higher residual GFR (P < 0.001). Multivariate analysis showed that diabetes [hazard ratio(HR) 1.64, P < 0.05] and RRF (per 1 ml/min/1.73 m2 increase, HR 0.81, P < 0.01) were independent risk factors. Conclusion. Our study revealed that RRF and diabetes were risk factors for peritonitis. These results suggest that preservation of RRF should be viewed as a protective strategy to reduce peritonitis.

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