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首页> 外文期刊>Peritoneal dialysis international: Journal of the International Society for Peritoneal Dialysis >Residual renal function in a large cohort of peritoneal dialysis patients: change over time, impact on mortality and nutrition.
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Residual renal function in a large cohort of peritoneal dialysis patients: change over time, impact on mortality and nutrition.

机译：大量腹膜透析患者的残余肾功能：随着时间的变化，对死亡率和营养的影响。

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OBJECTIVE: Residual renal function contributes importantly to total solute clearance in peritoneal dialysis (PD) patients. This study was designed to examine the progression of residual renal function over time and its impact on nutrition and mortality in PD patients in the six New England states (ME, NH, VT, CT, MA, RI) comprising End Stage Renal Disease (ESRD) Network 1. DESIGN: As part of the ESRD Clinical Indicators Project, data on 990 PD patients in Network 1 were abstracted from data supplied by dialysis units in the fourth quarter of 1997. This included demographic information; dose of PD in L/day; weekly renal, dialysis, and total Kt/V urea; weekly renal, dialysis, and total creatinine clearance (CCr); serum albumin level; and mortality and transplantation information. Data collection was repeated in the second and fourth quarters of 1998 and in the second quarter of 1999. PATIENTS: 990 PD patients in Network 1. OUTCOME MEASURES: The change in total and renal solute clearances over time, the relationship between renal clearance and mortality, and the relationship between renal clearance and nutritional status, as represented by serum albumin. RESULTS: Over the 2-year period, mean weekly renal Kt/V urea and weekly renal CCr dropped significantly. To examine the effect of residual renal function on mortality, patients were divided into high and low (above and below the median) weekly renal Kt/V urea and weekly renal CCr groups. Patients above the median levels of both weekly renal Kt/V urea and weekly renal CCr had a significantly decreased risk of dying during the observation period, after controlling for age, gender, serum albumin level, and diabetic status [OR for high vs low renal Kt/V urea 0.54 (CI 0.34 - 0.84), OR for high vs low renal CCr 0.61 (CI 0.40 - 0.94)]. The mean weekly renal Kt/V urea was significantly and directly correlated with the mean serum albumin level by Spearman rank correlation (R = 0.133, p < 0.001), as was the mean weekly renal CCr (R = 0.115, p < 0.001). CONCLUSIONS: Residual renal function is an important contributor to total solute clearance in PD patients. Even at low levels it is linked to decreased mortality and better nutritional status.
机译：目的：残余肾功能对腹膜透析（PD）患者的总溶质清除率起重要作用。这项研究旨在检查包括终末期肾病（ESRD）在内的六个新英格兰州（ME，NH，VT，CT，MA，RI）残余肾功能随时间的进展及其对PD患者营养和死亡率的影响）网络1。设计：作为ESRD临床指标项目的一部分，从1997年第四季度透析部门提供的数据中提取了网络1中990名PD患者的数据。 PD的剂量，以升/天为单位;每周肾脏，透析和总Kt / V尿素;每周肾脏，透析和总肌酐清除率（CCr）;血清白蛋白水平;以及死亡率和移植信息。在1998年第二和第四季度以及1999年第二季度重复收集数据。患者：网络1中的990名PD患者。观察指标：总和肾脏溶质清除率随时间的变化，肾脏清除率与死亡率之间的关系，以及以血清白蛋白为代表的肾脏清除率与营养状况之间的关系。结果：在2年期间，平均每周肾脏Kt / V尿素和每周肾脏CCr显着下降。为了检查残余肾功能对死亡率的影响，将患者分为每周肾脏Kt / V尿素水平高和低（中位数以下）和每周肾脏CCr组。在控制了年龄，性别，血清白蛋白水平和糖尿病状态后，在观察期内，每周肾Kt / V尿素和每周肾CCr均高于中值的患者死亡风险显着降低[高肾或低肾的OR Kt / V尿素0.54（CI 0.34-0.84），或高或低肾CCr 0.61（CI 0.40-0.94）的OR]。每周平均肾Kt / V尿素与平均血清白蛋白水平通过Spearman等级相关性显着且直接相关（R = 0.133，p <0.001），以及每周平均肾脏CCr（R = 0.115，p <0.001）。结论：残余肾功能是PD患者总溶质清除率的重要因素。即使含量低，也与降低死亡率和改善营养状况有关。

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