Minimal and optimal peritoneal Kt/V targets: results of an anuric peritoneal dialysis patient's survival analysis.

Abstract

BACKGROUND:

Residual renal clearance has been shown to be much more predictive of survival than peritoneal clearance. There has been little data to support a target level of peritoneal clearance. A retrospective study was therefore conducted to see how the peritoneal Kt/V had affected the survival of anuric patients in our center.

METHODS:

Over a period of 10 years, there were 150 peritoneal dialysis patients with documented anuria. Their survival was analyzed according to their baseline peritoneal Kt/V at the time of documentation of anuria and at the time of their latest altered peritoneal dialysis (PD) prescription (subsequent Kt/V).

RESULTS:

There were 90 females and 42 diabetics. The mean age and duration of dialysis were 57.7 +/- 14.7 and 44.1 +/- 31.3 months, respectively. The 2-year and 5-year survival rates were 88.7% and 66.7%, respectively. We found that patients with baseline peritoneal Kt/V below 1.67 had poorer survival after the documentation of anuria than those above [relative risk (RR) 1.985, P= 0.01], although the baseline Kt/V was not an independent risk factors in the whole group of patients. However, such effect was mainly observed in female patients. The survival was identical between those with Kt/V above or below 1.80 (P= 0.98). Among female patients, the group with baseline Kt/V 1.67 to 1.86 had the best survival, followed by those greater than 1.86 and lowest in those below 1.67 (P= 0.0016). For patients with baseline Kt/V below 1.80, those with subsequent Kt/V above 1.76 had better survival than those below (P= 0.033).

CONCLUSION:

Our data suggested that a negative effect of peritoneal Kt/V on survival is apparent at a level below 1.67 and there exists a limit of its effect at around 1.80. We suggested a minimal Kt/V target of 1.70 and an optimal target at 1.80 in anuric patients based on survival data. Prospective randomized study is required to confirm this finding.

• Authors: Wai-Kei Lo, Sing-Leung Lui, Tak-Mao Chan, Fu-Keung Li, Man-Fai Lam, Kai-Chung Tse, Sydney Chi-Wai Tang, Cindy Bo-Ying Choy, Kar-Neng Lai
• Journal: Kidney international (Kidney Int) Vol. 67 Issue 5 Pg. 2032-8 (May 2005) ISSN: 0085-2538 [Print] United States
• PMID: 15840054 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Anuria (mortality, physiopathology, therapy)
• Biological Transport, Active
• Female
• Hong Kong (epidemiology)
• Humans
• Kidney (physiopathology)
• Kinetics
• Male
• Middle Aged
• Peritoneal Dialysis (mortality)
• Peritoneum (physiopathology)
• Retrospective Studies
• Survival Analysis