Simplified colonic dialysis with hemodialysis solutions delays the progression of chronic kidney disease.

Abstract

BACKGROUND:

The colon plays a vital role in the disposal of nitrogenous waste products. Therefore, the colon may provide a therapeutic target for managing chronic kidney disease (CKD).

AIM:

To evaluate the efficacy of a simplified model of colonic dialysis with hemodialysis solutions (SCD) to delay the progression of stages 3-5 CKD.

DESIGN:

Retrospective study.

METHODS:

We retrospectively analyzed 178 stages 3-5 CKD patients who did or did not receive SCD (SCD group, n = 88; control group, n = 90). The follow-up was 36 months. The outcome of CKD progression was defined as a decrease in 50% or more in estimated glomerular filtration rate, starting hemodialysis or peritoneal dialysis or undergoing transplantation. The Kaplan-Meier analysis was used to compare CKD progression between SCD and control groups as well as between subgroups at different CKD stages. Cox proportional hazard models adjusted for patients' characteristics were used to examine the association between SCD and the outcome.

RESULTS:

For all patients, the outcome was significantly better in SCD group compared to control group (P < 0.05). The results were similar in the subgroups of patients at stage 4 (P = 0.001) and stage 5 (P = 0.000), but not in the subgroup of patients at stage 3 (P = 0.121). For all patients, SCD was associated with a lower risk of CKD progression after adjusted for patients' characteristics (adjusted hazard ratio, 0.373; 95% confidence interval, 0.201-0.694; P 0.002).

CONCLUSION:

SCD is an effective supplementary therapy to delay the progression of stages 4-5 CKD.

• Authors: S Dai, Y Dai, J Peng, X Xie, J Ning
• Journal: QJM : monthly journal of the Association of Physicians (QJM) Vol. 112 Issue 3 Pg. 189-196 (Mar 01 2019) ISSN: 1460-2393 [Electronic] England
• PMID: 30407603 (Publication Type: Comparative Study, Journal Article)
• Copyright: © The Author(s) 2018. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For permissions, please email: [email protected].

Chemical References

• Hemodialysis Solutions

Topics

• Adult
• Aged
• China
• Colon (metabolism)
• Disease Progression
• Female
• Glomerular Filtration Rate
• Hemodialysis Solutions
• Humans
• Male
• Middle Aged
• Renal Dialysis (methods)
• Renal Insufficiency, Chronic (mortality, therapy)
• Retrospective Studies
• Risk Factors
• Survival Analysis
• Time Factors