Baseline and Time‐Averaged Values Predicting Residual Renal Function Decline Rate in Japanese Peritoneal Dialysis Patients. Issue 6 (19th October 2017)

• Record Type: Journal Article
• Authors: Uchiyama, Kiyotaka; Yanai, Akane; Maeda, Keizo; Ono, Keisuke; Honda, Kazuya; Tsujimoto, Ryuji; Kamijo, Yuka; Yanagi, Mai; Ishibashi, Yoshitaka
• Is Part Of: Therapeutic apheresis and dialysis. Volume 21:Issue 6(2017)
• Page Start: 599
• Page End: 605
• Publication Date: 2017-10-19
• Subjects: Mean blood pressure -- Peritoneal dialysis -- Residual renal function -- Urinary protein; Hemapheresis -- Periodicals; Dialysis -- Periodicals; Blood Component Removal -- Periodicals; Renal Dialysis -- Periodicals; Hémaphérèse -- Périodiques; Dialyse -- Périodiques; Sang -- Collecte et conservation -- Périodiques; 616
• DOI: 10.1111/1744-9987.12589
• Languages: English
• ISSNs: 1744-9979

Abstract

Abstract: Residual renal function (RRF) is a strong prognostic factor of morbidity and mortality in patients undergoing peritoneal dialysis (PD). We determined predictors of the RRF rate of decline using both baseline values and time‐averaged ones. We retrospectively analyzed 94 patients being treated with PD at the Japanese Red Cross Medical Center. The decline rate of RRF was calculated by a diminution in the weekly renal Kt/V between the first and last follow up divided by follow‐up years. The mean follow‐up period was 2.28 years, and the mean decline rate of weekly renal Kt/V was 0.25 per year. A multivariate analysis using baseline parameters identified dialysis‐to‐plasma ratios of creatinine at 4 h ( P = 0.02), urinary protein ( P = 0.02), and mean blood pressure (MBP) ( P < 0.01) as being positively associated with the RRF rate of decline, while the use of angiotensin converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) had a negative correlation ( P = 0.03). When using time‐averaged values as independent variables, a lower weekly total renal Kt/V ( P < 0.0001), higher urinary protein ( P < 0.0001), and higher MBP ( P = 0.04) independently predicted a faster RRF rate of decline. We demonstrated that PD patients with a lower MBP and lower urinary protein both at baseline and throughout their PD duration had a slower RRF rate of decline. We recommend strict control of blood pressure and anti‐proteinuric therapy for PD patients.