Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Importance of dialysis adequacy in mortality and morbidity of Chinese CAPDpatients
Autore:
Szeto, CC; Wong, TYH; Leung, CB; Wang, AYM; Law, MC; Lui, SF; Li, PKT;
Indirizzi:
Chinese Univ Hong Kong, Prince Wales Hosp, Dept Med, Shatin, Hong Kong, Peoples R China Chinese Univ Hong Kong Shatin Hong Kong Peoples R China Peoples R China
Titolo Testata:
KIDNEY INTERNATIONAL
fascicolo: 1, volume: 58, anno: 2000,
pagine: 400 - 407
SICI:
0085-2538(200007)58:1<400:IODAIM>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
AMBULATORY PERITONEAL-DIALYSIS; RESIDUAL RENAL-FUNCTION; HEMODIALYSIS-PATIENTS; UREA; SURVIVAL;
Keywords:
peritoneal dialysis; renal failure; end-stage renal disease; Kt/V; creatinine clearance;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: Szeto, CC Chinese Univ Hong Kong, Prince Wales Hosp, Dept Med & Therapeut,Shatin, Hong Kong, Peoples R China Chinese Univ Hong Kong Shatin Hong Kong Peoples R China China
Citazione:
C.C. Szeto et al., "Importance of dialysis adequacy in mortality and morbidity of Chinese CAPDpatients", KIDNEY INT, 58(1), 2000, pp. 400-407

Abstract

Background. In continuous ambulatory peritoneal dialysis (CAPD), the impact of dialysis adequacy on patient outcome is well established in Caucasian patients but is less clear in Asian patients. Recent evidence suggests thatAsian dialysis patients enjoy better overall survival. We hypothesize thatdialysis adequacy may be less important in determining outcome for this ethnic group. Methods. We performed a single-center prospective observational study. From September 1995, we enrolled 150 existing and 120 new CAPD patients. They were followed for up to three years. We monitored dialysis adequacy and nutritional indices, including Kt/V, weekly creatinine clearance (C-Cr), residual glomerular filtration rate (GFR), normalized protein catabolic rate (NPCR), percentage of lean body mass (%LBM), and plasma albumin level. Clinical outcomes included mortality, technique failure, and duration of hospitalization. Results. The duration of study follow-up was 22.1 +/- 12.3 months. In our study population, 136 were male. Seventy were diabetic (25.9%), and 212 were treated with 6 L exchanges per day (78.5%). The body weight was 59.3 +/- 9.4 kg. Baseline total Kt/V was 1.78 +/- 0.41, peritoneal Kt/V 1.48 +/- 0.36, and median residual GFR 0.98 mL/min (range 0 to 7.45). Two-year patient survival was 83.0%, and technique survival was 72.8%. Multivariate analysisshowed that the duration of dialysis, diabetes, %LBM, index of dialysis adequacy (Kt/V or C-Cr), residual GFR, and requirement of a helper for CAPD exchanges were independent factors of patient survival; serum albumin, adequacy index (Kt/V or C-Cr), and requirement of a helper were independent factors of technique survival. Duration of dialysis, body weight, requirement of helper, cardiovascular disease, HBsAg carrier, serum albumin, and C-Cr had independent effects on hospitalization. The peritoneal component of Kt/V or C-Cr had no independent effect on any outcome parameter. When the prevalent and new CAPD cases were analyzed separately, Kt/V predicted survival only for new CAPD cases. Conclusions. Our results show that dialysis adequacy has significant impact on outcome of Asian CAPD patients. Although we have excellent medium-termpatient and technique survival, this favorable outcome should not prevent health care workers from providing adequate dialysis to Asian patients. Thereason of discrepancy in outcome between Asian and Caucasian dialysis patients requires further study.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/12/20 alle ore 12:34:50