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Article: ASPD: A prospective study of adequacy in asian patients on long term, small volume, continuous ambulatory peritoneal dialysis

TitleASPD: A prospective study of adequacy in asian patients on long term, small volume, continuous ambulatory peritoneal dialysis
Authors
KeywordsAdequacy
Asian population
Body mass index
Dialysis volume
Issue Date2006
PublisherMultimed, Inc. The Journal's web site is located at http://pdiconnect.com
Citation
Peritoneal Dialysis International, 2006, v. 26 n. 4, p. 466-474 How to Cite?
Abstract◆ Background: The impact of small solute clearance on patient survival in continuous ambulatory peritoneal dialysis (CAPD) is not yet solidified. Previously, we demonstrated that CAPD using small volume (6 L) daily exchanges provides adequate dialysis for most Asian patients. ◆ Methods: We conducted a prospective, long-term observational study to determine the optimal dialysis adequacy that may provide better patient survival for Asian patients who receive small-volume CAPD. We recruited 294 patients. The initial CAPD regime was 3 × 2-L. exchanges daily. The same regime was maintained unless there was significant loss of ultrafiltration or fluid retention despite the use of hypertonic dialysate. ◆ Results: Median study period was 38.9 (range 5 - 76.5) months, with 81% and 27% of patients remaining in the study at 24 and 48 months respectively. The overall survival rates at 2 and 4 years were 94.0% and 74.8% respectively. Our Long-term data revealed that survival rate was related to Kt/V values. Survival rates were significantly higher for patients with total Kt/V > 2.0 than for patients with Kt/V < 1.7 (p = 0.02). The former group had lower body mass index and higher residual renal function and peritoneal Kt/V than the latter group. On analysis using Cox proportional hazards regression models, cardiovascular disease (CVD), lower urine volume, and higher body mass index were independent predictors of mortality. Patients with higher renal Kt/V had a significantly lower risk of mortality (RR = 0.018, p = 0.01) after adjusting for the effects of CVD and diabetes mellitus. ◆ Conclusion: Our data recommend that 1.7 be the minimal target for total Kt/V in patients on long-term CAPD. Patients with high body mass index, low residual urine volume, and significant CVD need close monitoring. Copyright © 2006 International Society for Peritoneal Dialysis.
Persistent Identifierhttp://hdl.handle.net/10722/78533
ISSN
2023 Impact Factor: 2.7
2023 SCImago Journal Rankings: 0.933
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLam, MFen_HK
dc.contributor.authorTang, Cen_HK
dc.contributor.authorWong, AKen_HK
dc.contributor.authorTong, KLen_HK
dc.contributor.authorYu, AWen_HK
dc.contributor.authorLi, CSen_HK
dc.contributor.authorCheung, KOen_HK
dc.contributor.authorLai, KNen_HK
dc.date.accessioned2010-09-06T07:43:56Z-
dc.date.available2010-09-06T07:43:56Z-
dc.date.issued2006en_HK
dc.identifier.citationPeritoneal Dialysis International, 2006, v. 26 n. 4, p. 466-474en_HK
dc.identifier.issn0896-8608en_HK
dc.identifier.urihttp://hdl.handle.net/10722/78533-
dc.description.abstract◆ Background: The impact of small solute clearance on patient survival in continuous ambulatory peritoneal dialysis (CAPD) is not yet solidified. Previously, we demonstrated that CAPD using small volume (6 L) daily exchanges provides adequate dialysis for most Asian patients. ◆ Methods: We conducted a prospective, long-term observational study to determine the optimal dialysis adequacy that may provide better patient survival for Asian patients who receive small-volume CAPD. We recruited 294 patients. The initial CAPD regime was 3 × 2-L. exchanges daily. The same regime was maintained unless there was significant loss of ultrafiltration or fluid retention despite the use of hypertonic dialysate. ◆ Results: Median study period was 38.9 (range 5 - 76.5) months, with 81% and 27% of patients remaining in the study at 24 and 48 months respectively. The overall survival rates at 2 and 4 years were 94.0% and 74.8% respectively. Our Long-term data revealed that survival rate was related to Kt/V values. Survival rates were significantly higher for patients with total Kt/V > 2.0 than for patients with Kt/V < 1.7 (p = 0.02). The former group had lower body mass index and higher residual renal function and peritoneal Kt/V than the latter group. On analysis using Cox proportional hazards regression models, cardiovascular disease (CVD), lower urine volume, and higher body mass index were independent predictors of mortality. Patients with higher renal Kt/V had a significantly lower risk of mortality (RR = 0.018, p = 0.01) after adjusting for the effects of CVD and diabetes mellitus. ◆ Conclusion: Our data recommend that 1.7 be the minimal target for total Kt/V in patients on long-term CAPD. Patients with high body mass index, low residual urine volume, and significant CVD need close monitoring. Copyright © 2006 International Society for Peritoneal Dialysis.en_HK
dc.languageengen_HK
dc.publisherMultimed, Inc. The Journal's web site is located at http://pdiconnect.comen_HK
dc.relation.ispartofPeritoneal Dialysis Internationalen_HK
dc.subjectAdequacyen_HK
dc.subjectAsian populationen_HK
dc.subjectBody mass indexen_HK
dc.subjectDialysis volumeen_HK
dc.titleASPD: A prospective study of adequacy in asian patients on long term, small volume, continuous ambulatory peritoneal dialysisen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0896-8608&volume=26&spage=466&epage=474&date=2006&atitle=ASPD:+A+prospective+study+of+adequacy+in+Asian+patients+on+long+term,+small+volume,+continuous+ambulatory+peritoneal+dialysisen_HK
dc.identifier.emailLai, KN: knlai@hku.hken_HK
dc.identifier.authorityLai, KN=rp00324en_HK
dc.description.naturelink_to_OA_fulltext-
dc.identifier.pmid16881342-
dc.identifier.scopuseid_2-s2.0-33748427363en_HK
dc.identifier.hkuros132132en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33748427363&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume26en_HK
dc.identifier.issue4en_HK
dc.identifier.spage466en_HK
dc.identifier.epage474en_HK
dc.identifier.isiWOS:000239577000011-
dc.publisher.placeCanadaen_HK
dc.identifier.scopusauthoridLam, MF=35300050600en_HK
dc.identifier.scopusauthoridTang, C=9036754800en_HK
dc.identifier.scopusauthoridWong, AK=7403147057en_HK
dc.identifier.scopusauthoridTong, KL=7102473456en_HK
dc.identifier.scopusauthoridYu, AW=7401478900en_HK
dc.identifier.scopusauthoridLi, CS=7409844347en_HK
dc.identifier.scopusauthoridCheung, KO=7402406558en_HK
dc.identifier.scopusauthoridLai, KN=7402135706en_HK
dc.identifier.issnl0896-8608-

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