| The Prognostic Factors for Long-term Maintenance of CAPD: Importance of Early %lean Body Mass and Peritonitis |
| Dong Ki Kim, M.D., Seung Hyeok Han, M.D., Jung Eun Lee, M.D. Sung Jin Moon, M.D., Hyun-Wook Kim, M.D., Jae Hyun Chang, M.D., Sun Young Park, M.D. Jung Tak Park, M.D., Beom Seok Kim, M.D., Shin-Wook Kang, M.D., Ho Yung Lee, M.D. Dae-Suk Han, M.D. and Kyu H |
| Department of Internal Medicine, Yonsei University, College of Medicine The Institute of Kidney Disease, Yonsei University, Seoul, Korea |
| 장기간 지속성 외래 복막투석 유지의 예후 인자: 초기 %제지방질량지수와 복막염의 중요성 |
| 김동기 한승혁 이정은 문성진 김현욱 장제현 박선영 박정탁 김범석 강신욱 이호영 한대석 최규헌 |
| 연세대학교 의과대학 내과학교실 신장내과, 신장질환연구소 |
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| Abstract |
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Purpose : Lower technical survival rate of CAPD compared to hemodialysis is still concerned. We aimed to evaluate the characteristics of long-term CAPD survivors in pre-dialysis and early phase of CAPD for estimating predictive markers for long-term maintenance of CAPD.
Methods : We retrospectively reviewed records of long-term CAPD patients (LT group, >100 months, n=51) and short-term patients (ST group, <50 months, n=102) who were age-sex matched with the LT group in a 2:1 ratio. Clinical characteristics, serial biochemical parameters, Kt/V, and peritoneal equilibrium test (PET) within 1 month and at 1 year of CAPD were analyzed.
Results : LT group had lower prevalence of diabetes, higher pre-dialysis serum albumin, creatinine, % LBM at 1 month of CAPD and lower peritonitis rate compared to ST group. However, dialysis adequacy, residual renal function and transport status showed no differences between two groups at 1 month and 1 year of CAPD. In multivariate analysis, diabetes, peritonitis rate and %LBM were independent risk factors for failure of long-term maintenance of CAPD. Moreover, patients with high %LBM were more likely to be in LT group, had longer CAPD maintenance duration, and lower peritonitis rate. In multiple linear regression analysis for risk factors associated with peritonitis, %LBM at 1 month and pre-dialysis serum albumin were independently associated with peritonitis rate.
Conclusion : The present study revealed that non-diabetic history, higher %LBM and lower peritonitis rate are important predictors of long-term CAPD survival. Also, poor nutritional status assessed by %LBM and serum albumin level was independently associated with high frequency of peritonitis. |
| Key Words:
Long-term survivors, Peritoneal dialysis, Malnutrition, Peritonitis |
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