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Reduced residual renal function is a risk of peritonitis in continuous ambulatory peritoneal dialysis patients

 Seung Hyeok Han  ;  Sang Choel Lee  ;  Dae-Suk Han  ;  Ho Yung Lee  ;  Kyu Hun Choi  ;  Shin-Wook Kang  ;  Beom Seok Kim  ;  Sung Jin Moon  ;  Tae Hee Lee  ;  Dong Ki Kim  ;  Jung Eun Lee  ;  Song Vogue Ahn 
 Nephrology Dialysis Transplantation, Vol.22(9) : 2653-2658, 2007 
Journal Title
 Nephrology Dialysis Transplantation 
Issue Date
BACKGROUND: Loss of residual renal function (RRF) contributes to anaemia, inflammation and malnutrition and is also a strong predictor of mortality in continuous ambulatory peritoneal dialysis (CAPD) patients. However, the role of RRF on peritonitis is not yet clearly established. This study aimed to evaluate the effect of RRF on the development of peritonitis. METHODS: Study subjects were 204 end-stage renal disease (ESRD) patients who started PD from January 2000 to December 2005. Biochemical and clinical data within 1 month of PD commencement were considered as baseline. To determine risk factors for peritonitis, multivariate Cox regression was performed. Kaplan-Meier analysis and log-rank test were used to examine the difference of peritonitis-free period according to the presence of diabetes and RRF. RESULTS: On univariate analysis based on baseline data in first peritonitis, diabetes was less prevalent and RRF (6.7+/-2.6 vs 4.0+/-2.3 ml/min/1.73 m2, P<0.01), haemoglobin (10.9+/-1.2 vs 10.6+/-1.2 g/dl, P<0.05) and serum albumin level (3.6+/-0.4 vs 3.4+/-0.4 g/dl, P<0.01) were significantly higher in the peritonitis-free group. Kaplan-Meier analysis showed that time to first PD peritonitis episode was significantly longer in the non-diabetic patients (P<0.001) and in patients with higher residual GFR (P<0.001). Multivariate analysis showed that diabetes [hazard ratio(HR) 1.64, P<0.05] and RRF (per 1 ml/min/1.73 m2 increase, HR 0.81, P<0.01) were independent risk factors. CONCLUSION: Our study revealed that RRF and diabetes were risk factors for peritonitis. These results suggest that preservation of RRF should be viewed as a protective strategy to reduce peritonitis.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
강신욱(Kang, Shin Wook) ORCID logo https://orcid.org/0000-0002-5677-4756
김동기(Kim, Dong Ki)
김범석(Kim, Beom Seok) ORCID logo https://orcid.org/0000-0002-5732-2583
문성진(Moon, Sung Jin)
이정은(Lee, Jung Eun) ORCID logo https://orcid.org/0000-0003-0917-2872
이태희(Lee, Tae Hee)
이호영(Lee, Ho Yung)
최규헌(Choi, Kyu Hun) ORCID logo https://orcid.org/0000-0003-0095-9011
한대석(Han, Dae Suk)
한승혁(Han, Seung Hyeok) ORCID logo https://orcid.org/0000-0001-7923-5635
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