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KMID : 0359920100290060752
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Korean Journal of Nephrology
2010 Volume.29 No. 6 p.752 ~ p.760
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Risk Factors Influencing Decline of Residual Renal Function
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Kim Gun-Hyun
Hyun Seung-Hyea
Seo Hye-Jin
Choi Ji-Young
Cho Ji-Hyung
Kim Chan-Duck
Park Sun-Hee
Kim Yong-Lim
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Abstract
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Purpose: Preservation of residual renal function (RRF) after initiation of peritoneal dialysis (PD) is beneficial for patient survival. It is unclear that same risk factors of pre-dialysis chronic kidney disease (CKD) patients affect RRF in PD patients. This study was aimed to evaluate factors affecting RRF after commencement of PD.
Methods: Data from 80 patients commencing CAPD at Kyungpook National University Hospital between January 2001 and December 2008 were retrospectively collected. After PD commencement, biochemical and clinical data at baseline (1 month), 6, and 12 month were obtained. RRF was calculated as the average of creatinine clearance and urea nitrogen clearance from 24-hour urine collection and normalized with body surface area and mean RRF decline rate was
calculated by dividing RRF difference between baseline to 12 month by period.
Results:Mean RRF decline rate (mL/min/1.73m2/month) was negatively correlated with left ventricular posterior wall thickness (LVPWT) (R2=0.097, p=0.023) and proteinuria (R2=0.126, p=0.003), whereas positively correlated with hematocrit (R2=0.076, p=0.013) at baseline. Comparison between the two groups divided by median RRF decline rate (-0.082 mL/min/1.73m2/month) showed that baseline proteinuria (p<0.001), the number of antihypertensive agents (p=0.030) and LVPWT (p=0.039) were higher in the decline group. In addition, the number of antihypertensive agents was higher in the decline group at 1 year, although there was no difference of blood pressure between the two groups. Using multiple binary logistic regression, it was shown that more rapid RRF decline (<-0.082 mL/min/1.73m2/month) was likely to have higher proteinuria [adjusted odd ratio (AOR) 3.310, 95% confidence interval (CI) 1.363-8.041], and thicker LVPWT [AOR 1.682, 95% CI 1.043-2.711] at baseline.
Conclusion: Decline of RRF during a year after commencement of PD was associated with baseline proteinuria and LVPWT.
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KEYWORD
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Continuous ambulatory peritoneal dialysis, Proteinuria, Left ventricular hypertrophy
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