[Factors related to residual renal function loss in patients in peritoneal dialysis]

Rev Med Inst Mex Seguro Soc. Sep-Oct 2015;53(5):578-83.
[Article in Spanish]

Abstract

Background: Residual renal function (RRF) contributes to the quality of life of patients on dialysis. The preservation of RRF is associated with higher patient survival in peritoneal dialysis (PD), and is now accepted that RRF and peritoneal clearance are not of equal value in patient survival. The aim of this study is to know the factors related to RRF loss in prevalent patients in continuous ambulatory peritoneal dialysis (CAPD).

Methods: This is an analysis of secondary outcomes. Forty-three adult patients with type 2 diabetes were included. They had RRF preserved. Clinical and laboratory assessments were done in each visit during a year.

Results: The male gender (p = 0.042), systolic (p = 0.009) and diastolic (p = 0.006) blood pressure (BP), hemoglobin (p = 0.008), peritoneal creatinine clearance (p = 0.014), peritoneal ultrafiltration (p = 0.017) and levels of tumor necrosis factor-alpha (TNF-alpha) in plasma (p = 0.022) and dialysate (p = 0.008) were related with RRF loss.

Conclusions: It is important to understand the factors associated with RRF loss in our patients to prevent the gradual loss and its implications on the mortality and quality of life.

Introducción: la conservación de la función renal residual (FRR) en los pacientes en diálisis peritoneal (DP) tiene una clara influencia sobre la calidad de vida, independientemente de que su preservación ha demostrado influir en la mayor supervivencia de los pacientes. El objetivo del presente estudio fue conocer los factores relacionados con pérdida de la FRR en un grupo de pacientes prevalentes en diálisis peritoneal continua ambulatoria (DPCA). Métodos: se trata de un estudio de análisis de resultados secundarios. Se incluyeron 43 adultos con diabetes tipo 2 (DT2), con FRR conservada, a quienes se les dio seguimiento durante un año. Resultados: los factores relacionados con la pérdida de la FRR fueron: género masculino (p = 0.042), presión arterial sistólica (p = 0.009) y diastólica (p = 0.006), hemoglobina (p = 0.008), aclaramiento peritoneal de creatinina (p = 0.014), ultrafiltración (p = 0.017), niveles de factor de necrosis tumoral alfa (FNT–alfa) en plasma (p = 0.022) y dializado (p = 0.008). Conclusiones: es importante conocer los factores relacionados con pérdida de la FRR en nuestros pacientes para evitar la pérdida gradual de la misma y sus implicaciones sobre la mortalidad y calidad de vida.

Keywords: Kidney diseases; Peritoneal dialysis; Renal insufficiency.

MeSH terms

  • Adult
  • Aged
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetic Nephropathies / etiology
  • Diabetic Nephropathies / physiopathology*
  • Diabetic Nephropathies / therapy*
  • Female
  • Humans
  • Kidney / physiopathology*
  • Kidney Failure, Chronic / etiology
  • Kidney Failure, Chronic / physiopathology*
  • Kidney Failure, Chronic / therapy*
  • Kidney Function Tests
  • Male
  • Middle Aged
  • Peritoneal Dialysis, Continuous Ambulatory*