Yonsei Med J.  2014 Jan;55(1):141-148. 10.3349/ymj.2014.55.1.141.

Effect of Peritoneal Dialysis Modality on the 1-Year Rate of Decline of Residual Renal Function

• Kim CH
• Oh HJ
• Lee MJ
• Kwon YE
• Kim YL
• Nam KH
• Park KS
• An SY
• Ko KI
• Koo HM
• Doh FM
• Han SH
• Yoo TH
• Kim BS
• Kang SW
• Choi KH

• KMID: 1779898
• DOI: http://doi.org/10.3349/ymj.2014.55.1.141

Abstract

PURPOSE
The effect of different peritoneal dialysis (PD) modalities on the decline in residual renal function (RRF) is unclear due to inconsistencies among studies. In particular, the effect of automated peritoneal dialysis (APD) modalities [continuous cyclic peritoneal dialysis (CCPD) and nightly intermittent peritoneal dialysis (NIPD)] on RRF has not been examined in a large cohort.
MATERIALS AND METHODS
We conducted a single-center retrospective study to investigate the association between PD modalities and decline in RRF in 142 incident PD patients [34 on CCPD, 36 on NIPD, and 72 on continuous ambulatory peritoneal dialysis (CAPD)]. RRF was measured within 2 months from PD start and at 1 year after PD initiation.
RESULTS
The RRF at 1 year after PD initiation was 1.98+/-2.20 mL/min/1.73 m2 in CCPD patients and 3.63+/-3.67 mL/min/1.73 m2 in NIPD patients, which were moderately lower than 4.23+/-3.51 mL/min/1.73 m2 in CAPD patients (p=0.064). Moreover, there was no significant difference in the 1-year rate of decline of RRF between CCPD and NIPD patients, although APD patients had a faster 1-year RRF decline rate than CAPD patients (CCPD and NIPD vs. CAPD: -45.68 and -36.69 vs. 1.17%/year, p=0.045). APD was associated with a more rapid decline in RRF in patients with end-stage renal disease undergoing PD, although multivariate analysis attenuated the significance of this finding (beta=-31.50; 95% CI, -63.61 to 0.62; p=0.052).
CONCLUSION
Our results suggest that CAPD might be more helpful than APD for preserving RRF during the first year of dialysis therapy, although there was no significant difference in the 1-year rate of decline of RRF between the two APD modalities.

Keyword

Continuous ambulatory peritoneal dialysis; end-stage kidney disease; glomerular filtration rate; peritoneal dialysis

MeSH Terms

Adult
Female
Glomerular Filtration Rate/physiology
Humans
Kidney/pathology/physiopathology
Kidney Failure, Chronic/*therapy
Male
Middle Aged
Peritoneal Dialysis/*adverse effects
Retrospective Studies

Figure

• 

  Fig. 1 Decline of residual renal function in CCPD patients (A), NIPD patients (B), and CAPD patients (C) from baseline to 1-year after PD initiation. CCPD, continuous cyclic peritoneal dialysis; NIPD, nightly intermittent peritoneal dialysis; CAPD, continuous ambulatory peritoneal dialysis; PD, peritoneal dialysis.

• 

  Fig. 2 Comparison of the 1-year rate of decline of residual renal function among the three groups.*vs. CAPD group, p<0.05. CCPD, continuous cyclic peritoneal dialysis; NIPD, nightly intermittent peritoneal dialysis; CAPD, continuous ambulatory peritoneal dialysis.

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  Fig. 3 Comparison of the 1-year rate of decline of urine volume among the three groups. CCPD, continuous cyclic peritoneal dialysis; NIPD, nightly intermittent peritoneal dialysis; CAPD, continuous ambulatory peritoneal dialysis.

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