J Korean Med Sci.  2010 Sep;25(9):1313-1317. 10.3346/jkms.2010.25.9.1313.

High Peritoneal Transport Status is Not an Independent Risk Factor for High Mortality in Patients Treated with Automated Peritoneal Dialysis

• Chang TI
• Park JT
• Lee DH
• Lee JH
• Yoo TH
• Kim BS
• Kang SW
• Lee HY
• Choi KH

• KMID: 1785910
• DOI: http://doi.org/10.3346/jkms.2010.25.9.1313

Abstract

We undertook this study to elucidate whether baseline peritoneal membrane transport characteristics are associated with high mortality in incident automated peritoneal dialysis (APD) patients. This retrospective study includes 117 patients who started APD at Yonsei University Health System from 1996 to 2008 and had a PET within 3 months of APD initiation. High transporters were significantly older and had a higher incidence of cardiovascular disease. Patient survival for years 1, 3, and 5 were 85%, 64%, and 35% for high transporter and 94%, 81%, and 68% for non-high transporter group (P<0.01). Multivariate analysis revealed that age, diabetes, cardiovascular disease, serum albumin level, and residual renal function were independently associated with high mortality in APD patients. In contrast, high transport status was not a significant predictor for mortality in this population when the other covariates were included. Even though high transport was significantly associated with mortality in the univariate analysis, its role seemed to be influenced by other comorbid conditions. These findings suggest that the proper management of these comorbid conditions, as well as appropriate ultrafiltration by use of APD and/or icodextrin, must be considered as protective strategies to improve survival in peritoneal dialysis patients with high transport.

Keyword

Automated Peritoneal Dialysis; High Transport; Peritoneal Equilibration Test; Mortality

MeSH Terms

Adult
Age Factors
Aged
Aged, 80 and over
Automation
Cardiovascular Diseases/complications
Diabetes Complications
Dialysis Solutions/therapeutic use
Female
Glomerular Filtration Rate
Glucans/therapeutic use
Glucose/therapeutic use
Humans
Kidney Failure, Chronic/therapy
Male
Middle Aged
Multivariate Analysis
Peritoneal Dialysis/*mortality
Retrospective Studies
Risk Factors
Serum Albumin/analysis
Survival Rate

Figure

• 

  Fig. 1 Kaplan-Meier survival plots for patient survival according to peritoneal transport type. The survival rate was significantly higher for the patients who were in the nonhigh transport group (P<0.01).

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