| Significance of Peritoneal Protein Clearance in Peritoneal Dialysis Patients |
| Sul Hee Yi, M.D., Ho Young Lee, M.D., Jung hyun Kim, M.D., Jae Myun Jung, M.D., Soon Hyo Kwon, M.D., Jin Seok Jeon, M.D., Dong Cheol Han, M.D. and Hyunjin Noh, M.D. |
| Department of Internal Medicine, Soon Chun Hyang University |
| 원저 : 복막투석 환자의 예후를 예측하는 인자로서 총 단백 복막 청소율의 의의 |
| 이설희, 이호영, 김정현, 정재면, 권순효, 전진석, 한동철, 노현진 |
| 순천향대학교 의과대학 내과학교실 신장내과, 현암신장연구소 |
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| Abstract |
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Purpose: It has been reported recently that peritoneal protein clearance (Pcl) is a marker of endothelial dysfunction and cardiovascular disease in peritoneal dialysis patients. We evaluated whether baseline or longitudinal follow-up Pcl is a factor to consider in predicting the outcome in peritoneal dialysis patients for the follow-up period.
Methods: Patients who initiated continuous ambulatory peritoneal dialysis at our center from September 1994 to January 2006 and had a baseline peritoneal equilibration test, measurement of dialysis adequacy, and 24-h dialysate Pcl (24hr dialysate protein loss/ [serum albumin/0.4783]) were included. Demography, comorbidities, and biochemical data were retrospectively collected. Follow-up was until death or the end of the period studied (November 2009).
Results: A total of 203 patients (56% men, mean age 55.0±12.5; 55.2% with diabetes; 22.2% with cardiovascular disease) were included. The mean follow up period was 38 months (3-170 months). Baseline Pcl was 128.2 ml/day. Follow up data of Pcl were not changed from baseline period. Cox’s analysis revealed the predictors of mortality (and technical failure) were age and diabetes mellitus but not dialysate/plasma creatinine ratio (D/Pcr) and Pcl. On multivariate analysis, Pcl was negatively correlated with serum albumin and triglyceride and positively correlated with D/Pcr and peritoneal creatinine clearance.
Conclusion: Our study showed that the changes in Pcl over time were not significant from baseline up to 53 months. Neither baseline nor mean Pcl during the follow-up period were independent predictors for technical or patient survival. |
| Key Words:
Peritoneal fluid, Protein, Peritoneal dialysis, Treatment outcome |
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