The Effect of Serum Albumin at the Start of Continuous Ambulatory Peritoneal Dialysis Treatment on Patient Survival

1994 ◽  
Vol 14 (2) ◽  
pp. 121-126 ◽  
Author(s):  
Dirk G. Struijk ◽  
Raymond T. Krediet ◽  
Gerardus C.M. Koomen ◽  
Elisabeth W. Boeschoten ◽  
Lambertus Arisz
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Patient Survival ◽  
Cox Model ◽  
Medical Center ◽  
Systemic Disease ◽  
Ideal Body Weight ◽  
Plasma Urea ◽  
Lower Survival Rate

Objective To analyze the effect of serum albumin using immunoturbidimetry, demographic, biochemical, and kinetic factors on survival of continuous ambulatory peritoneal dialysis (CAPD) patients. Design A review of prospectively collected data in a 2-year follow-up study of peritoneal transport kinetics. Setting University medical center. Participants Sixty-one patients, evaluated within 3 months after the start of CAPD. Main Outcome Measures Covariables used in the survival analysis were plasma urea, and creatinine, albumin, hemoglobin, mass transfer area coefficient of creatinine, peritoneal albumin clearance, 4-hour peritoneal albumin loss, net ultrafiltration, age, blood pressure, body mass index, difference between actual and ideal body weight, and presence or absence of systemicdisease. Results Overall survival was 64% at 2 years. Median serum albumin was 30.9 g/L, range 18.1 -43.9 g/L. Patients with a serum albumin below the median had a lower survival rate than those higher than the median (2-year survival 49% vs 79%, p = 0.01). Using the Cox model, survival was related to systemic disease (p = 0.004), age (p = 0.02), hemoglobin (p = 0.03), and serum albumin (p = 0.1). Conclusions The results confirm the strength of serum albumin as predictor of survival. However, in this study serum albumin merely reflected the presence of a systemic disease, which was the most important risk factor for patient survival.

scholarly journals Impact of Dialysis Adequacy on the Mortality and Morbidity of Anuric Chinese Patients Receiving Continuous Ambulatory Peritoneal Dialysis

2001 ◽  
Vol 12 (2) ◽  
pp. 355-360 ◽  
Author(s):  
CHEUK-CHUN SZETO ◽  
TERESA YUK-HWA WONG ◽  
KAI-MING CHOW ◽  
CHI-BON LEUNG ◽  
MAN-CHING LAW ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Patient Survival ◽  
Residual Renal Function ◽  
The Body ◽  
Chinese Patients ◽  
Dialysis Adequacy ◽  
Technique Survival

Abstract. Dialysis adequacy has a major impact on the outcome of continuous ambulatory peritoneal dialysis (CAPD) patients. However, most studies on peritoneal dialysis adequacy have focused on patients with significant residual renal function. The present study examined the effect of dialysis adequacy on anuric CAPD patients. A single-center prospective observational study on 140 anuric CAPD patients was performed. These patients were followed for 22.0 ± 11.9 mo. Dialysis adequacy and nutritional indices, including Kt/V, creatinine clearance (CCr), protein equivalent nitrogen appearance, percentage of lean body mass, and serum albumin level were monitored. Clinical outcomes included actuarial patient survival, technique survival, and duration of hospitalization. In the study population, 64 were male, 36 (25.7%) were diabetic, and 59 (42.1%) were treated with 6 L exchanges per day. The body weight was 59.2 ± 10.2 kg. Average Kt/V was 1.72 ± 0.31, and CCr was 43.7 ± 11.5 L/wk per 1.73m2. Two-yr patient survival was 68.8%, and technique survival was 61.4%. Multivariate analysis showed that DM, duration of dialysis before enrollment, serum albumin, and index of dialysis adequacy (Kt/V or CCr) were independent factors of both patient survival and technique survival. It was estimated that for two patients who differed only in weekly Kt/V, a 0.1 higher value was associated with a 6% decrease in the RR of death (P < 0.05; 95% confidence interval, 0.92 to 0.99). Serum albumin and CCr were the only independent factors that predicted hospitalization. It was found that even when there is no residual renal function, higher dialysis dosage is associated with better actuarial patient survival, better technique survival, and shorter hospitalization. Dialysis adequacy has a significant impact on the clinical outcome of CAPD patients, and the beneficial effect is preserved in anuric patients as well as in an ethnic group that has a low overall mortality.

Adverse Prognostic Indicators in Continuous Ambulatory Peritoneal Dialysis Patients without Obvious Vascular or Nutritional Comorbidities

2003 ◽  
Vol 23 (2_suppl) ◽  
pp. 109-115 ◽  
Author(s):  
Ping-Nam Wong ◽  
Siu-Ka Mak ◽  
Kin-Yee Lo ◽  
Gensy M.W. Tong ◽  
Yuk Wong ◽  
...  
Keyword(s):  
Body Weight ◽  
Peritoneal Dialysis ◽  
Body Size ◽  
Serum Albumin ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Patient Survival ◽  
Vascular Events ◽  
Dialysis Adequacy ◽  
Technique Survival ◽  
Risk Of Death

Objectives Factors that predict the occurrence of vascular events and poor patient survival in continuous ambulatory peritoneal dialysis (CAPD) patients have not been clearly defined. Previous studies have focused on nonselective CAPD patients, in whom pre-existing comorbidity or poor health might complicate interpretation of the significance of individual factors. The present study was conducted with CAPD patients without severe vascular and nutritional comorbidity. Patients and Methods This single-center, prospective, observational study was conducted with 66 prevalent CAPD patients without co-existing severe vascular or nutritional problems. The patients were enrolled in January 1999. We monitored baseline demographic data and clinical and laboratory characteristics including average clinic blood pressure (BP), hemoglobin (Hb), serum albumin, intact parathyroid hormone (iPTH), serum cholesterol, triglycerides, dialysate-to-plasma (D/P) creatinine, dialysis adequacy [Kt/V and creatinine clearance (CCr)], and protein equivalent of nitrogen appearance. We followed the patients for 3 years. Outcome measures were actuarial patient survival, time to occurrence of cerebrovascular accident (CVA) and acute myocardial infarction (AMI), technique survival, and hospitalization rate. Results Mean age of the patients was 56.7 ± 10.3 years. Mean duration on CAPD at the time of enrollment was 36.4 ± 21.7 months. Nineteen of the patients (28.8%) had diabetes. Most of the patients [ n = 55 (83.3%)] were using three 2-L exchanges daily. Mean body weight was 56.3 ± 12.2 kg. Mean total weekly Kt/V was 1.91 ± 0.47, and mean total weekly CCr was 75.3 ± 30.6 L/1.73 m2. Actuarial patient survival was 96.9% at 1 year, 90.5% at 2 years, and 75.3% at 3 years. Overall technique survival was 96.9% at 1 year, 95.1% at 2 years, and 89.1% at 3 years. Multivariate analysis showed that age, diabetes mellitus (DM), and body size (weight or surface area) were independent predictors of patient survival. We estimated that a 1-kg increase in body weight was associated with a 6% increase in the relative risk of death ( p = 0.015; 95% confidence interval: 1.013 to 1.126). Patients with a body weight of 60 kg or less showed a significantly better 3-year survival as compared with patients with body weight greater than 60 kg (88.1% vs 58.3%, p = 0.0042). No significant predictors were identified for technique failure or occurrence of a major vascular event. High BP and DM were independent predictors for hospitalization. Dialysis adequacy indices and serum albumin showed no significant effect on any outcome measure. Conclusions Our study showed that, in addition to age and DM, body size could also be a significant factor affecting survival of CAPD patients. However, the underlying causative mechanisms remain unclear and require further study.

Is Target Kt/V and Patient Survival Different between Asian and Western Continuous Ambulatory Peritoneal Dialysis (Capd) Patients?

1999 ◽  
Vol 19 (2_suppl) ◽  
pp. 27-31 ◽  
Author(s):  
Wai-Kei Lo ◽  
Ignatius K.-P. Cheng ◽  
Sing-Leung Lui ◽  
Tak-Mao Chan ◽  
Fu-Keung Li ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Patient Survival

Predictors of Survival in Continuous Ambulatory Peritoneal Dialysis Patients: A Five-Year Prospective Study

1996 ◽  
Vol 16 (1_suppl) ◽  
pp. 190-194 ◽  
Author(s):  
Morrell M. Avram ◽  
Paul A. Fein ◽  
Luigi Bonomini ◽  
Neal Mittman ◽  
Raphael Loutoby ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Tertiary Care ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Term Survival ◽  
Predictors Of Mortality

Our objective was to examine the influence of various demographic, clinical, and enrollment biochemical variables on the long-term survival of continuous ambulatory peritoneal dialysis (CAPD) patients. This was a prospective cohort study investigating the relationship between demographics and enrollment biochemical markers and mortality in CAPD patients in a CAPD unit in a large tertiary care teaching hospital. One hundred and sixtynine patients in the CAPD program were enrolled between 1989 and 1994, and were followed up to 60 months. Independent predictors of mortality determined by Cox proportional hazards model included age, diabetes, serum albumin and creatinine. Enrollment level of serum albumin, and creatinine can predict mortality in CAPD patients up to 60 months. Markers of visceral and somatic nutrition at enrollment are important predictors of mortality in CAPD patients up to five years.

scholarly journals Five-year experience of continuous ambulatory peritoneal dialysis in children: a single center experience in a developing country

2019 ◽  
Vol 28 (4) ◽  
pp. 329-37 ◽  
Author(s):  
Cahyani Gita Ambarsari ◽  
Partini Pudjiastuti Trihono ◽  
Agustina Kadaristiana ◽  
Taralan Tambunan ◽  
Lily Mushahar ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Patient Survival ◽  
Survival Rates ◽  
Published Data ◽  
Hospital Data ◽  
Technique Survival ◽  
Single Center Experience ◽  
Number Of Patients ◽  
Stage Renal Disease

BACKGROUND The pediatric peritoneal dialysis (PD) program in Cipto Mangunkusumo Hospital, Indonesia was started in 2014. However, there has been no published data on the patients’ outcome. This study was aimed to report the characteristics and outcomes of a continuous ambulatory peritoneal dialysis (CAPD) program for children. METHODS This retrospective study was conducted in Cipto Mangunkusumo Hospital as a national referral hospital. Data were collected from medical records of patients aged ≤18 years with end-stage renal disease who underwent CAPD in 2014–2019. The baseline characteristics, PD-related infection rate, as well as patient and technique survivals were analyzed. RESULTS Out of 60 patients who underwent CAPD, 36 (60%) were boys on the age range of 4 months–18 years. The mean follow-up duration was 12 (95% confidence interval [CI] = 9.4–15.3) months. The number of PD related infections increased along with the growing number of patients on CAPD. The peritonitis rate was 0.42 episodes per year at risk, and the most common etiology was alpha-hemolytic Streptococcus (5/24, [20.8%]). The 1- and 3-year technique survival rates were 60.3% (95% CI = 44.5–72.9) and 43.9% (95% CI = 23.2–62.9). The 1- and 3-year patient survival rates were 69.6% (95% CI = 52.5–81.5) and 58% (95% CI = 31.2–77.5). CONCLUSIONS In this unit, CAPD could be performed in children as young as 4 months of age. The peritonitis rate was relatively low which was likely caused by skin-derived microorganisms. Both technique survival and patient survival were also relatively low.

scholarly journals Risk Factors for Mortality in Chinese Patients on Continuous Ambulatory Peritoneal Dialysis

2015 ◽  
Vol 35 (2) ◽  
pp. 199-205 ◽  
Author(s):  
Fan Zhang ◽  
Hong Liu ◽  
Xiaoli Gong ◽  
Fuyou Liu ◽  
Youming Peng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Patient Survival ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Hazards Model ◽  
Kaplan Meier

ObjectiveThe intent of this study was to evaluate the clinical outcome and risk factors affecting mortality of the continuous ambulatory peritoneal dialysis (CAPD) patients in a single peritoneal dialysis (PD) center over a period of 10 years.Patients and methodsWe retrospectively analyzed patients on PD from June 2001 to June 2011. The clinical and biochemical data were collected from the medical records. Clinical variables included gender, age at the start of PD, smoking status, body mass index (BMI), cause of end-stage renal disease (ESRD), presence of diabetes mellitus and blood pressure. Biochemical variables included hemoglobin, urine volume, residual renal function (RRF), serum albumin, blood urea nitrogen (BUN), creatinine, total cholesterol, triglyceride, comorbidities, and outcomes. Survival curves were made by the Kaplan-Meier method. Univariate and multivariate analyses to identify mortality risk factors were performed using the Cox proportional hazard regression model.ResultsA total of 421 patients were enrolled, 269 of whom were male (63.9%). The mean age at the start of PD was 57.9 ± 14.8 years. Chronic glomerulonephritis was the most common cause of ESRD (39.4%). Estimation of patient survival by Kaplan-Meier was 92.5%, 80.2%, 74.4%, and 55.7% at 1, 3, 5, and 10 years, respectively. Patient survival was associated with age (hazard ratio [HR]: 1.641 [1.027 – 2.622], p = 0.038), cardiovascular disease (HR: 1.731 [1.08 – 2.774], p = 0.023), hypertriglyceridemia (HR: 1.782 [1.11 – 2.858], p = 0.017) in the Cox proportional hazards model analysis. Estimation of technique survival by Kaplan-Meier was 86.7%, 68.8%, 55.7%, and 37.4% at 1, 3, 5, and 10 years, respectively. In the Cox proportional hazards model analysis, age (HR: 1.672 [1.176 – 2.377], p = 0.004) and hypertriglyceridemia (HR: 1.511 [1.050 – 2.174], p = 0.026) predicted technique failure.ConclusionThe PD patients in our center exhibited comparable or even superior patient survival and technical survival rates, compared with reports from other centers in China and other countries.

scholarly journals Increased peritoneal membrane transport is associated with decreased patient and technique survival for continuous peritoneal dialysis patients. The Canada-USA (CANUSA) Peritoneal Dialysis Study Group.

1998 ◽  
Vol 9 (7) ◽  
pp. 1285-1292 ◽  
Author(s):  
D N Churchill ◽  
K E Thorpe ◽  
K D Nolph ◽  
P R Keshaviah ◽  
D G Oreopoulos ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Membrane Transport ◽  
Patient Survival ◽  
Peritoneal Membrane ◽  
Dialysis Patients ◽  
Technique Survival ◽  
Survival Probabilities ◽  
The Mean ◽  
Technique Failure

The objective of this study was to evaluate the association of peritoneal membrane transport with technique and patient survival. In the Canada-USA prospective cohort study of adequacy of continuous ambulatory peritoneal dialysis (CAPD), a peritoneal equilibrium test (PET) was performed approximately 1 mo after initiation of dialysis; patients were defined as high (H), high average (HA), low average (LA), and low (L) transporters. The Cox proportional hazards method evaluated the association of technique and patient survival with independent variables (demographic and clinical variables, nutrition, adequacy, and transport status). Among 606 patients evaluated by PET, there were 41 L, 192 LA, 280 HA, and 93 H. The 2-yr technique survival probabilities were 94, 76, 72, and 68% for L, LA, HA, and H, respectively (P = 0.04). The 2-yr patient survival probabilities were 91, 80, 72, and 71% for L, LA, HA, and H, respectively (P = 0.11). The 2-yr probabilities of both patient and technique survival were 86, 61, 52, and 48% for L, LA, HA, and H, respectively (P = 0.006). The relative risk of either technique failure or death, compared to L, was 2.54 for LA, 3.39 for HA, and 4.00 for H. The mean drain volumes (liters) in the PET were 2.53, 2.45, 2.33, and 2.16 for L, LA, HA, and H, respectively (P < 0.001). After 1 mo CAPD treatment, the mean 24-h drain volumes (liters) were 9.38, 8.93, 8.59, and 8.22 for L, LA, HA, and H, respectively (P < 0.001); the mean 24-h peritoneal albumin losses (g) were 3.1, 3.9, 4.3, and 5.6 for L, LA, HA, and H, respectively (P < 0.001). The mean serum albumin values (g/L) were 37.8, 36.2, 33.8, and 32.8 for L, LA, HA, and H, respectively (P < 0.001). Among CAPD patients, higher peritoneal transport is associated with increased risk of either technique failure or death. The decreased drain volume, increased albumin loss, and decreased serum albumin concentration suggest volume overload and malnutrition as mechanisms. Use of nocturnal cycling peritoneal dialysis should be considered in H and HA transporters.

Serum C-Reactive Protein: A Predictor of Mortality in Continuous Ambulatory Peritoneal Dialysis Patients

1998 ◽  
Vol 18 (4) ◽  
pp. 387-394 ◽  
Author(s):  
Hyunjin Noh ◽  
Seoung Woo Lee ◽  
Shin Wook Kang ◽  
Sug Kyun Shin ◽  
Kyu Hun Choi ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Peritoneal Dialysis ◽  
Survival Rate ◽  
Outcome Measures ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Patient Survival ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Significant Difference ◽  
Patient Survival Rate

Objective To evaluate the predictive value of a single baseline serum C-reactive protein (sCRP) as a marker of mortality in continuous ambulatory peritoneal dialysis (CAPD) patients. Design A review of prospectively collected data in a 2-year follow-up study. Setting Tertiary medical center. Patients The study included 106 patients who were stable and had been on CAPD for a minimum of 3 months. Main Outcome Measures Patient survival rate was the main outcome measure of this study. Other outcome measures were technique survival rate, peritonitis rate, and hospitalized days. Covariables used in the survival analysis were age, sex, the presence of cardiovascular disease or diabetes mellitus, sCRP, serum albumin, hematocrit, cholesterol, HDL-cholesterol, malnutrition by subjective global assessment (SGA), weekly Kt/V urea, and weekly standardized creatinine clearance (SCCr). Results The 2-year patient survival rate was significantly lower in the increased sCRP group than in the normal sCRP group (66.7% vs 94.1%, p = 0.001), although there was no significant difference in technique failure, peritonitis rate, and hospitalized days between the two groups. By Cox proportional hazards analysis, independent predictors of mortality were: cardiovascular disease (relative risk, RR = 8.96, p < 0.005); increased sCRP level (RR = 1.19, p < 0.05); and high hematocrit (RR = 1.18, p < 0.05). ← Conclusion Serum CRP at enrollment is an independent predictor of 2-year patient survival in CAPD patients.

scholarly journals Continuous Ambulatory Peritoneal Dialysis in Limpopo Province, South Africa: Predictors of Patient and Technique Survival

2014 ◽  
Vol 34 (5) ◽  
pp. 518-525 ◽  
Author(s):  
Ramon A. Tamayo Isla ◽  
Darlington Mapiye ◽  
Charles R. Swanepoel ◽  
Nadiya Rozumyk ◽  
Jerome E. Hubahib ◽  
...  
Keyword(s):  
South Africa ◽  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Tap Water ◽  
Average Distance ◽  
Limpopo Province ◽  
Composite Outcome ◽  
Technique Survival ◽  
At Home

Introduction and aimContinuous ambulatory peritoneal dialysis (CAPD) is not a frequently used modality of dialysis in many parts of Africa due to several socio-economic factors. Available studies from Africa have shown a strong association between outcome and socio-demographic variables. We sought to assess the outcome of patients treated with CAPD in Limpopo, South Africa.MethodsThis was a retrospective study of 152 patients treated with CAPD at the Polokwane Kidney and Dialysis Centre (PKDC) from 2007 to 2012. We collected relevant demographic and biochemical data for all patients included in the study. A composite outcome of death while still on peritoneal dialysis (PD) or CAPD technique failure from any cause requiring a change of modality to hemodialysis (HD) was selected. The peritonitis rate and causes of peritonitis were assessed from 2008 when all related data could be obtained.ResultsThere were 52% males in the study and the average age of the patients was 36.8 ± 11.4 years. Unemployment rate was high (71.1%), 41.1% had tap water at home, the average distance travelled to the dialysis center was 122.9 ± 78.2 kilometres and half the patients had a total income less than USD ($)180 per month. Level of education, having electricity at home, having tap water at home, body mass index (BMI), serum albumin and hemoglobin were significantly different between those reaching the composite outcome and those not reaching it ( p < 0.05). The overall peritonitis rate was 0.82/year with 1-year, 2-year and 5-year survival found to be 86.7%, 78.7% and 65.3% (patient survival) and 83.3%, 71.7% and 62.1% (technique survival). Predictors of the composite outcome were BMI ( p = 0.011), serum albumin ( p = 0.030), hemoglobin ( p = 0.002) and more than 1 episode of peritonitis ( p = 0.038).ConclusionTreatment of anemia and malnutrition as well as training and re-training of CAPD patients and staff to prevent recurrence of peritonitis can have positive impacts on CAPD outcomes in this population.

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