Introduction:
The positive impact of residual renal function (RRF) on the total amount of weekly clearances of small molecules, improvement of cardiac function and surviving in peritoneal dialysis (PD) is well known. On the other hand, poor nutritional status and volume overload in these patients are recognized as negative prognostic factors. In our study we analyzed impact of RRF on nutritional status and volume control in our patients.
Methods:
We retrospectively investigated 53 chronic PD patients with at least a 5-year history of PD treatment; RRF was determined by a daily diuresis more than 200ml. We analyzed nutritional (percentage body fat, serum albumin concentration, creatinine, transferrin, normalized protein catabolic rate) and volume parameters (EF, BNP and BCM).
Results:
Patients were classified into two groups: with RRF (mean, 550 ml; range, 210-2400 ml), N=38; and without RRF (mean, 45 ml; range, 0-200 ml), N=15. Total Kt/V urea being equal in both groups (2,15 ±0,2 and 2,08±0,1). There were no significantly difference in age, gender distribution, previous history of heart attack or revascularization of myocardium, diabetes mellitus comorbidity, peritoneal membrane transport characteristic, percentage of body fat, transferrin, albumin and creatinine concentration. Total duration of dialysis and mean normalized protein catabolic rate in patients with RRF were 6,1±0,8 years and 1,12 g/kg/day, EF and BNP were 52±6,2% and 796±21 pg/ml which were significantly (P<0.01) different than those in patients without RRF (5,3±0,6years, 0,91 g/kg/day, 38±4,5% and 2434±81pg/ml). Number of overhidration patients was also higher in group without RRF (p<0.01).
Conclusions:
Almost two third of our PD patients had sufficient RRF, majority with shorter duration on PD. In our research, we have shown that RRF alone can beneficially influence nutritional parameters, control of volume status and preservation of left ventricular function, which consequently can significantly improve survival of patients and PD modality option.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.