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Definition and Risk Factors of Rapidly Declining Residual Renal Function in Peritoneal Dialysis: An Observational Study
- Source :
- Kidney and Blood Pressure Research. 35:233-241
- Publication Year :
- 2012
- Publisher :
- S. Karger AG, 2012.
-
Abstract
- Background: It is critical to preserve residual renal function (RRF) in peritoneal dialysis (PD), as RRF is associated with lower morbidity and mortality. There is no uniform definition of RRF, and rapidly declining RRF has rarely been studied and predominately limited to single factor analysis and not corrected for lead-time bias. Methods: An observational study in 71 incident PD patients. RRF was defined as urine output (UO) ≥500 ml/day and renal glomerular filtration rate (rGFR) ≥2 ml/min/1.73 m2, rapid declining RRF as UO 2 occurring within 6 months which were separately evaluated. Independent risk factors associated with rapid RRF decline were identified while correcting for lead-time bias. Results: RRF declined rapidly by both definitions in 65% patients 2.5 years after PD start. Both definitions of RRF decline were consistent in 96%. Nephrotoxic drugs, renal transplant failure and absent angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB) were independent risk factors associated with rapidly declining RRF defined both by definitions, intravascular radiocontrast additionally for UO decline. Conclusions: Most PD patients demonstrated rapid RRF decline, independent of its definition. Both definitions are highly consistent and interchangeable. Nephrotoxic drugs and radiocontrast were identified as risk factors of acute, absent ACEI or ARB, and renal transplant failure of chronic renal injury.
- Subjects :
- Adult
Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Medizin
Urology
Renal function
Angiotensin II Receptor Blockers
Kidney
Kidney Function Tests
End stage renal disease
Nephrotoxicity
Peritoneal dialysis
Cohort Studies
Risk Factors
Internal medicine
medicine
Humans
Longitudinal Studies
Urine output
Aged
Retrospective Studies
business.industry
General Medicine
Middle Aged
Endocrinology
Nephrology
Renal transplant
Female
Observational study
Cardiology and Cardiovascular Medicine
business
Peritoneal Dialysis
Glomerular Filtration Rate
Subjects
Details
- ISSN :
- 14230143 and 14204096
- Volume :
- 35
- Database :
- OpenAIRE
- Journal :
- Kidney and Blood Pressure Research
- Accession number :
- edsair.doi.dedup.....6ed2f02db0f3ca695c8d48d6aa6aa56a