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January 1, 2019Kidney & Blood Pressure ResearchOpen Access

A Fast Decline of Residual Renal Function in the First Year is a Predictor for Early Withdrawal from Peritoneal Dialysis in Non-Diabetic Patients

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Key result

A fast decline of residual renal function in the first year of peritoneal dialysis increased the risk of all-cause mortality and conversion to hemodialysis (HR 2.74; 95% CI 1.53-4.90; P=0.001).

Why the study?

Little is known about the relationship between early residual renal function decline and survival in non-diabetic peritoneal dialysis patients.

Does a fast decline of residual renal function predict all-cause mortality and conversion to hemodialysis in non-diabetic peritoneal dialysis patients?

Population

567 non-diabetic patients starting peritoneal dialysis

Comparison

High RRF decline (>0.308 ml/min/1.73m2/month) vs low RRF decline (≤0.308 ml/min/1.73m2/month)

Design

Cohort study

Follow-up

Median 43 months

Authors

JWJunni WangCommunication University of ZhejiangXXXishao XieYantai UniversityXYXingqun YanFirst Affiliated Hospital Zhejiang University

Discussion

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Member takes

Overview

Early RRF decline monitoring may aid prognostication in non-diabetic PD; leaves open whether preservation strategies improve survival.

Study Design

Type

Cohort (n=567)

Structured PICO

Does a fast decline of residual renal function predict all-cause mortality and conversion to hemodialysis in non-diabetic peritoneal dialysis patients?

P
Population
567 non-diabetic patients who began peritoneal dialysis, followed for a median of 43 months.
E
Exposure
High rate of residual renal function (RRF) decline (> 0.308 ml/min/1.73m2/month) in the first year
C
Comparator
Low rate of RRF decline (≤0.308 ml/min/1.73m2/month) in the first year
O
Outcome
Composite end-point of all-cause mortality and conversion to hemodialysis (HD)composite

Main Result

Hazard Ratio: 2.74 (95% CI 1.53–4.9)

Absolute Event Rate: 23.2% vs 11%

p-value: p=0.001

A faster decline in residual renal function during the first year of peritoneal dialysis is a strong predictor of all-cause mortality and conversion to hemodialysis in non-diabetic patients.

Cite This Study

Wang et al. (2019) conducted a cohort in Non-diabetic peritoneal dialysis (n=567). Fast decline of residual renal function (RRF) in the first year vs. Low RRF decline (≤0.308 ml/min/1.73m2/month) was evaluated on Composite of all-cause mortality and conversion to hemodialysis (HR 2.74, 95% CI 1.53-4.90, p=0.001). A fast decline of residual renal function in the first year of peritoneal dialysis increased the risk of all-cause mortality and conversion to hemodialysis (HR 2.74; 95% CI 1.53-4.90; P=0.001).

synapsesocial.com/papers/6a8b16539ac394ad33caa49dhttps://doi.org/10.1159/000497807
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1High Peritoneal KT/V and Peritonitis Rates Are Associated with Peritoneal Calcification2013 · 11 citations
  2. 2Measurement of residual renal function in patients treated with continuous ambulatory peritoneal dialysis.1996 · 239 citations
  3. 3Predictive value of dialysis adequacy and nutritional indices for mortality and morbidity in CAPD and HD patients. A longitudinal study1995 · 334 citations
  4. 4Risk Factors Influencing the Decline of Residual Renal Function in Continuous Ambulatory Peritoneal Dialysis Patients1999 · 83 citations
  5. 5Predictors of Residual Renal Function Decline in Peritoneal Dialysis Patients: The bal ANZ Trial2016 · 48 citations