Original InvestigationDialysisAssociation of Kt/V and Creatinine Clearance With Outcomes in Anuric Peritoneal Dialysis Patients
Section snippets
Methods
The study population included individuals on PD therapy with anuria receiving care in a Dialysis Clinic Inc unit or the New Haven continuous ambulatory PD unit. Patients included prevalent and incident patients on PD therapy between January 1, 1994, and January 31, 2005. Data for all individuals were obtained from the computerized medical record and provided as a fully de-identified file. Patients and caregivers are instructed to indicate anuria in this record or report anuria at the time of
Patient Population
There were 1,770 PD patients with anuria in the data set. Three hundred thirty-eight individuals were excluded from the analysis (268 without a clearance measure after anuria, 25 developed ESRD before age 18, and 45 with inaccurate data making calculation of dialysis time [vintage] not possible [eg, date of death before date of anuria]). After eliminating these individuals, there were 1,428 PD patients with an available Kt/V value at the onset of anuria and 1,416 with a Ccr value. Individuals
Discussion
In a group of anuric US PD patients, many of whom were overweight, we found that Kt/V less than 1.7 (calculated using actual body weight) was associated with increased risk of mortality and hospitalization, and this result persisted after multivariable adjustment. Kt/V of 1.7 to 2.0 compared with Kt/V greater than 2.0 was not independently associated with adverse outcomes in these anuric patients. These results confirming the KDOQI 2006 minimum Kt/V of 1.7 in anuric patients are important
Acknowledgements
The data were presented, in part, at the North America Chapter Meeting of the International Society for Peritoneal Dialysis, Hollywood, FL, June 1-3, 2007.
Support: None.
Financial Disclosure: Dr Hebah is an employee of Dialysis Clinic Inc.
References (25)
- et al.
Effect of Kt/V on survival and clinical outcome in CAPD patients in a randomized prospective study
Kidney Int
(2003) - et al.
Minimal and optimal peritoneal Kt/V targets: Results of an anuric peritoneal dialysis patient's survival analysis
Kidney Int
(2005) - et al.
Predictors of survival in anuric peritoneal dialysis patients
Kidney Int
(2005) - et al.
Total body water volumes for adult males and females estimated from simple anthropometric measurements
Am J Clin Nutr
(1980) - et al.
Mortality among hemodialysis patients in Europe, Japan, and the United States: Case-mix effects
Am J Kidney Dis
(2004) - et al.
Randomized prospective study of the effect of increased dialytic dose on nutritional and clinical outcome in continuous ambulatory peritoneal dialysis patients
Am J Kidney Dis
(2000) K/DOQI Clinical Practice Guidelines for Peritoneal Dialysis Adequacy: Update 2000
Am J Kidney Dis
(2001)Adequacy of dialysis and nutrition in continuous peritoneal dialysis: Association with clinical outcomesCanada-USA (CANUSA) Peritoneal Dialysis Study Group
J Am Soc Nephrol
(1996)- et al.
Effects of increased peritoneal clearances on mortality rates in peritoneal dialysis: ADEMEX, a prospective, randomized, controlled trial
J Am Soc Nephrol
(2002) - et al.
Relative contribution of residual renal function and peritoneal clearance to adequacy of dialysis: A reanalysis of the CANUSA Study
J Am Soc Nephrol
(2001)
KDOQI Clinical Practice Guidelines for Peritoneal Adequacy, Update 2006
Am J Kidney Dis
The 2006 K/DOQI guidelines for peritoneal dialysis adequacy are not adequate
Blood Purif
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Originally published online as doi:10.1053/j.ajkd.2008.05.013 on July 3, 2008.