Residual Renal Function and Effect of Low-Sodium Solution on Blood Pressure in Peritoneal Dialysis Patients

BackgroundResidual renal function (RRF) affects sodium and fluid balance. The aim of this analysis was to examine the impact of RRF on the effect of a sodium-reduced peritoneal dialysis fluid (PDF) on blood pressure (BP).MethodsThis is a post-hoc analysis of a prospective, randomized, controlled double-blind clinical trial with 82 patients on continuous ambulatory PD (CAPD) treated with a low-sodium (125 mmol/L Na) or a standard-sodium (134 mmol/L Na) PDF. Subgroups according to glomerular filtration rate (GFR) at baseline (≤ / > 6 mL/min/1.73 m2) were analyzed for BP and antihypertensive medication.ResultsIn the low-GFR group on low-sodium PDF ( N = 26), systolic BP was reduced from 152 ± 24 mmHg at baseline to 137 ± 21 mmHg at week 12, diastolic BP from 90 ± 16 mmHg to 83 ± 11 mmHg. In the low-GFR group on standard-sodium PDF and in the high-GFR group on both PDF types, only minor changes were observed. For the low-GFR subgroup, the confounder-adjusted mean study group difference in systolic BP at week 12 between low-sodium and standard-sodium PDF was -16.9 (95% confidence interval [CI] -27.2 to -6.6) mmHg, for diastolic BP, it was -7.0 (95% CI -12.6 to -1.4) mmHg. In both GFR subgroups, more patients had a reduced daily dose of antihypertensive medication and fewer patients an increased daily dose in the low-sodium compared with the standard-sodium group at week 12.ConclusionsThe reduction of BP with a sodium-reduced PDF seems to be more effective in patients with no or low RRF than in patients with residual capacity of renal sodium and fluid control.

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Risk Factors for Early Mortality in U.S. Peritoneal Dialysis Patients: Impact of Residual Renal Function

Peritoneal Dialysis International ◽

10.1177/089686080202200312 ◽

2002 ◽

Vol 22 (3) ◽

pp. 371-379 ◽

Cited By ~ 45

Author(s):

◽

Michael V. Rocco ◽

Diane L. Frankenfield ◽

Barbara Prowant ◽

Pamela Frederick ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Renal Function ◽

Peritoneal Dialysis ◽

Serum Albumin ◽

Creatinine Clearance ◽

Residual Renal Function ◽

Chronic Peritoneal Dialysis ◽

Dialysis Patients ◽

The Mean

Background Potential risk factors for 1-year mortality, including the peritoneal component of dialysis dose, residual renal function, demographic data, hematocrit, serum albumin, dialysate-to-plasma creatinine ratio, and blood pressure, were examined in a national cohort of peritoneal dialysis patients randomly selected for the Centers for Medicare and Medicaid Services End-Stage Renal Disease (ESRD) Core Indicators Project. Methods The study involved retrospective analysis of a cohort of 1219 patients receiving chronic peritoneal dialysis who were alive on December 31, 1996. Results During the 1-year follow-up period, 275 patients were censored and 200 non censored patients died. Among the 763 patients who had at least one calculable adequacy measure, the mean [± standard deviation (SD)] weekly Kt/V urea was 2.16 ± 0.61 and the mean weekly creatinine clearance was 66.1 ± 24.4 L/1.73 m2. Excluding the 365 patients who were anuric, the mean (±SD) urinary weekly Kt/V urea was 0.64 ± 0.52 (median: 0.51) and the mean (±SD) urinary weekly creatinine clearance was 31.0 ± 23.3 L/1.73 m2 (median: 26.3 L/1.73 m2). By Cox proportional hazard modeling, lower quartiles of renal Kt/V urea were predictive of 1-year mortality; lower quartiles of renal creatinine clearance were of borderline significance for predicting 1-year mortality. The dialysate component of neither the weekly creatinine clearance nor the weekly Kt/V urea were predictive of 1-year mortality. Other predictors of 1-year mortality ( p < 0.01) included lower serum albumin level, older age, and the presence of diabetes mellitus as the cause of ESRD, and, for the creatinine clearance model only, lower diastolic blood pressure. Conclusion Residual renal function is an important predictor of 1-year mortality in chronic peritoneal dialysis patients.

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Visit-to-Visit Variability in Systolic Blood Pressure Is a Risk Factor for Rapid Loss of Residual Renal Function in Peritoneal Dialysis Patients

The Tohoku Journal of Experimental Medicine ◽

10.1620/tjem.235.295 ◽

2015 ◽

Vol 235 (4) ◽

pp. 295-304 ◽

Cited By ~ 2

Author(s):

Hyung Ah Jo ◽

Jung Nam An ◽

Jung Pyo Lee ◽

Kook-Hwan Oh ◽

Chun Soo Lim ◽

...

Keyword(s):

Blood Pressure ◽

Renal Function ◽

Risk Factor ◽

Peritoneal Dialysis ◽

Systolic Blood Pressure ◽

Residual Renal Function ◽

Dialysis Patients ◽

Rapid Loss

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Comparative study on the efficacy of peritoneal dialysis and hemodialysis in patients with end-stage diabetic nephropathy

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.36.7.2901 ◽

2020 ◽

Vol 36 (7) ◽

Author(s):

Xiao-dong Xu ◽

Xue Han ◽

Yi Yang ◽

Xu Li

Keyword(s):

Blood Pressure ◽

Renal Function ◽

Diabetic Nephropathy ◽

Peritoneal Dialysis ◽

Comparative Study ◽

Systolic Pressure ◽

Residual Renal Function ◽

Creative Commons ◽

Significant Difference ◽

End Stage

Objective: Diabetic nephropathy is a serious threat to human health, and its incidence is on the rise. End-stage diabetic nephropathy (ESDN) requires extra investigation due to its complexity and severity, as well as serious concurrent diseases. Our objective was to compare the efficacy of hemodialysis (HD) and peritoneal dialysis (PD) in the treatment of ESDN. Methods: Clinical data of 84 patients with ESDN admitted to our hospital from June 2016 to June 2018 were retrospectively analyzed. The patients were divided into an HD group that received hemodialysis and a PD group that received peritoneal dialysis. Their general conditions, biochemical indicators, residual renal function and incidence of complications were recorded and compared between the two groups. Results: (1) No significant difference in diastolic blood pressure, systolic blood pressure, body weight, or urine output was detected between the two groups at the beginning of dialysis (P>0.05). (2) Compared to the PD group, the HD group had significantly lower total cholesterol (TC) and triglyceride (TG) (P<0.05), and significantly higher total protein (TP) and albumin (ALB) after treatment (P<0.05). (3) The two groups also showed significant difference in residual renal function after treatment (P<0.05). (4) The HD group had significantly higher systolic pressure than the PD group after treatment (P<0.05). And more cases of infection were observed in the PD group than the HD group (P<0.05). Conclusion: Both HD and PD are used for treatment of ESDN, and can achieve similar calcium and phosphorus control. Compared to HD, PD has less adverse effect on hemodynamics and better preserves residual renal function, but is more likely to cause malnutrition and disorders of lipid metabolism. Therefore, choice of dialysis method should be based on specific conditions of each patient. doi: https://doi.org/10.12669/pjms.36.7.2901 How to cite this:Xu XD, Han X, Yang Y, Li X. Comparative study on the efficacy of peritoneal dialysis and hemodialysis in patients with end-stage diabetic nephropathy. Pak J Med Sci. 2020;36(7):---------. doi: https://doi.org/10.12669/pjms.36.7.2901 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Risk Factors Influencing the Decline of Residual Renal Function in Continuous Ambulatory Peritoneal Dialysis Patients

Peritoneal Dialysis International ◽

10.1177/089686089901900211 ◽

1999 ◽

Vol 19 (2) ◽

pp. 138-142 ◽

Cited By ~ 45

Author(s):

Sug Kyun Shin ◽

Hyunjin Noh ◽

Shin Wook Kang ◽

Bo Jung Seo ◽

In Hee Lee ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Renal Function ◽

Risk Factor ◽

Peritoneal Dialysis ◽

Independent Risk Factor ◽

Residual Renal Function ◽

Logarithmic Scale ◽

Linear Scale ◽

Factors Influencing

Objective To assess the nature of the decline in residual renal function (RRF) after the initiation of peritoneal dialysis, and to identify risk factors influencing the preservation of RRF. Design A retrospective single-center study. Setting Tertiary medical center. Patients Eighty patients who were clinically stable and had been on continuous ambulatory peritoneal dialysis (CAPD) for a minimum of 6 months. Main Outcome Measures All subjects had at least three measurements of RRF, which was calculated as the average of creatinine clearance (Ccr) and urea clearance from a 24-hour urine collection. All measurements of RRF were plotted on a logarithmic scale and a linear scale against the duration of CAPD. Covariables used in the correlation analyses were age, sex, the presence of diabetes mellitus, mean blood pressure, mean diastolic blood pressure, hematocrit and Ccr at the start of peritoneal dialysis, peritoneal membrane transport characteristics by peritoneal equilibration test (PET), and the rate of peritonitis. Results A significant correlation was found between CAPD duration and RRF decline represented on a logarithmic scale with a correlation coefficient ( r) of 0.355 ( p < 0.001). In contrast, on a linear scale, the correlation coefficient was only 0.273 ( p < 0.01). By linear multiple regression analysis, the only independent risk factor for the decline of RRF was the rate of peritonitis ( r = -0.446, p < 0.001). Conclusion These results suggest that RRF declines exponentially rather than linearly with time, and that the rate of peritonitis is an independent risk factor for the decline of RRF in CAPD patients.

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Pharmacokinetic and Dynamic of Furosemide in Peritoneal Dialysis Patients

Peritoneal Dialysis International ◽

10.3747/pdi.2014.00328 ◽

2016 ◽

Vol 36 (1) ◽

pp. 107-108 ◽

Cited By ~ 1

Author(s):

Caroline Lamarche ◽

Maude Pichette ◽

Denis Ouimet ◽

Michel Vallée ◽

Robert Bell ◽

...

Keyword(s):

Blood Pressure ◽

Renal Function ◽

Peritoneal Dialysis ◽

Pressure Effect ◽

Urine Volume ◽

Residual Renal Function ◽

Dialysis Patients ◽

Blood Pressure Effect ◽

Health Canada

The aim of our study was to evaluate the efficacy and bioavailibility of a commonly used oral furosemide dose (500 mg) compared to a 250 mg intravenous (IV) dose in PD patients with significant residual renal function (urine volume > 100 mL). We also evaluated the immediate blood pressure effect in these patients. The data were obtained from a study we performed for the homologation of a 500-mg dose of furosemide by Health Canada.

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