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      Importance of Residual Renal Function in Continuous Ambulatory Peritoneal Dialysis: Its Influence on Different Parameters of Renal Replacement Treatment

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          Abstract

          Objective: To study the influence of residual renal function (RRF) on different parameters of the renal substitutive treatment offered by peritoneal dialysis. Methods: We analyzed the impact of RRF on dialysis dose, nutrition parameters, anemia and phosphocalcic metabolism in 37 patients with end-stage renal disease (ESRD) treated by continuous ambulatory peritoneal dialysis (CAPD). Analytical controls were done every 6 months after an initial assessment at the end of the first month of treatment. Multiple lineal regression models were used as the statistical method to analyze the influence of RRF on different theoretically dependent factors. RRF was calculated as a mean of creatinine and urea clearances. Three observations per patient were used: one at the end of the first month of treatment; a final one at the end of follow-up (mean time 24.2 ± 11.4 months), and at a mean time between them (13.4 ± 6.7 months), with a final number of 111 observations. Results: Dialysis dose: RRF was the most important factor in terms of creatinine clearance (r<sup>2</sup> = 0.94; β = 0.999), KT/V (r<sup>2</sup> = 0.68; β = 0.819) and β<sub>2</sub>-microglobulin levels (r<sup>2</sup> = 0.46; β = –0.489). Nutrition parameters: RRF was a determinant factor for normalized protein catabolic rate (r<sup>2</sup> = 0.53; β = 0.471), percent lean body mass (r<sup>2</sup> = 0.45; β = 0.446) and albumin levels (r<sup>2</sup> = 0.25; β = 0.229). Anemia: RRF was the most important factor when studying hemoglobin levels (r<sup>2</sup> = 0.28; β = 0.407). Phosphocalcic metabolism: Between the analyzed factors, RRF was the only one which reached significance on serum phosphate levels (r<sup>2</sup> = 0.19; β = –0.594). RRF did not show any relationship with either calcium or PTH levels. Conclusions: Independent of other factors, RRF in CAPD is positively and directly related to dialysis dose, β<sub>2</sub>-microglobulin levels, nutrition parameters (albumin, normalized protein catabolic rate and percent lean body mass, hemoglobin and serum phosphate levels.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          1999
          November 1999
          13 October 1999
          : 83
          : 3
          : 219-225
          Affiliations
          aDepartment of Nephrology, Clinical Hospital, University of Valencia, bDepartment of Nephrology, General Hospital, University of Alicante, and cStatistics Department, University of Valencia, Spain
          Article
          45514 Nephron 1999;83:219–225
          10.1159/000045514
          10529628
          546d72ad-0f44-4e90-8901-d1c87ba7d04a
          © 1999 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          History
          Page count
          Tables: 4, References: 29, Pages: 7
          Categories
          Original Paper

          Cardiovascular Medicine,Nephrology
          Residual renal function,Chronic renal failure,Peritoneal dialysis

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