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The Impact of Fluid Overload and Variation on Residual Renal Function in Peritoneal Dialysis Patient.

Tian N, Guo Q, Zhou Q, Cao P, Hong L, Chen M, Yang X, Yu X - PLoS ONE (2016)

Bottom Line: The decline rate of mGFR in both PO and IO groups were significantly faster than that of NH group (PO vs NH: -0.2 vs -0.1 ml/min/1.73 m2/month, p < 0.01; IO vs NH: -0.2 vs -0.1 ml/min/1.73 m2/month, p < 0.01).Kaplan-Meier analysis showed poorer RRF outcome in both PO and IO groups compared with that of NH group (PO vs NH: p < 0.001; IO vs NH: p = 0.006).Adjusted Cox regression models indicated the hazard ratio of RRF loss in PO group was 8.90-folds higher (95% confidence interval 3.07-31.89) than that in NH group.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Key Laboratory of Nephrology, Ministry of Health and Guangdong Province, Guangzhou, China.

ABSTRACT

Background: The effect of fluid overload and variation on residual renal function (RRF) in peritoneal dialysis (PD) patients is controversial.

Methods: Retrospective cohort study was designed. One-hundred and ninety PD patients with measured glomerular filtration rate (mGFR) ≧ 3 ml/min/1.73 m2 were recruit. Fluid status of every participant was assessed by bioelectrical impedance analysis (BIA) every 3 months for 1 year. The cohort was divided into three hydration groups, namely persistent overhydration (PO) group, intermittent overhydration (IO) group and normal hydration (NH) group. Additionally, participants were also divided into high or low fluid variation groups. The decline rate of RRF and the event of anuria were followed up for 1 year. The association of fluid overload with RRF loss was evaluated by Cox proportional hazard models adjusted for confounders.

Results: Thirty-six (18.9%) patients developed anuria. The decline rate of mGFR in both PO and IO groups were significantly faster than that of NH group (PO vs NH: -0.2 vs -0.1 ml/min/1.73 m2/month, p < 0.01; IO vs NH: -0.2 vs -0.1 ml/min/1.73 m2/month, p < 0.01). Kaplan-Meier analysis showed poorer RRF outcome in both PO and IO groups compared with that of NH group (PO vs NH: p < 0.001; IO vs NH: p = 0.006). Patients with high fluid variation had worse RRF survival than those with low fluid variation (p = 0.04). Adjusted Cox regression models indicated the hazard ratio of RRF loss in PO group was 8.90-folds higher (95% confidence interval 3.07-31.89) than that in NH group.

Conclusions: These findings suggested fluid overload was independently associated with the decline of RRF in PD patients.

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Related in: MedlinePlus

Kaplan-Meier survival curves for the residual renal function survival (event defined as anuria) in the persistent overhydration (PO) group, intermittent overhydration (IO) group, and the normal hydration (NH) group.In the multiple comparisons, the level of test was adjusted to 0.05/3 = 0.017.
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pone.0153115.g002: Kaplan-Meier survival curves for the residual renal function survival (event defined as anuria) in the persistent overhydration (PO) group, intermittent overhydration (IO) group, and the normal hydration (NH) group.In the multiple comparisons, the level of test was adjusted to 0.05/3 = 0.017.

Mentions: Totally, 36 (19%) patients developed anuria, 18 (31%) cases in the PO group, 13 (24%) in the IO group, and 5 (6%) in the NH group, respectively (Fig 1). The Kaplan-Meier curve for RRF loss showed that the patients in PO and IO groups had poorer RRF survival rate compared with that of NH patients (PO vs NH: Log-rank chi-square = 14.6, p < 0.001; IO vs NH: Log-rank chi-square = 7.4, p = 0.006) (Fig 2).


The Impact of Fluid Overload and Variation on Residual Renal Function in Peritoneal Dialysis Patient.

Tian N, Guo Q, Zhou Q, Cao P, Hong L, Chen M, Yang X, Yu X - PLoS ONE (2016)

Kaplan-Meier survival curves for the residual renal function survival (event defined as anuria) in the persistent overhydration (PO) group, intermittent overhydration (IO) group, and the normal hydration (NH) group.In the multiple comparisons, the level of test was adjusted to 0.05/3 = 0.017.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4836661&req=5

pone.0153115.g002: Kaplan-Meier survival curves for the residual renal function survival (event defined as anuria) in the persistent overhydration (PO) group, intermittent overhydration (IO) group, and the normal hydration (NH) group.In the multiple comparisons, the level of test was adjusted to 0.05/3 = 0.017.
Mentions: Totally, 36 (19%) patients developed anuria, 18 (31%) cases in the PO group, 13 (24%) in the IO group, and 5 (6%) in the NH group, respectively (Fig 1). The Kaplan-Meier curve for RRF loss showed that the patients in PO and IO groups had poorer RRF survival rate compared with that of NH patients (PO vs NH: Log-rank chi-square = 14.6, p < 0.001; IO vs NH: Log-rank chi-square = 7.4, p = 0.006) (Fig 2).

Bottom Line: The decline rate of mGFR in both PO and IO groups were significantly faster than that of NH group (PO vs NH: -0.2 vs -0.1 ml/min/1.73 m2/month, p < 0.01; IO vs NH: -0.2 vs -0.1 ml/min/1.73 m2/month, p < 0.01).Kaplan-Meier analysis showed poorer RRF outcome in both PO and IO groups compared with that of NH group (PO vs NH: p < 0.001; IO vs NH: p = 0.006).Adjusted Cox regression models indicated the hazard ratio of RRF loss in PO group was 8.90-folds higher (95% confidence interval 3.07-31.89) than that in NH group.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Key Laboratory of Nephrology, Ministry of Health and Guangdong Province, Guangzhou, China.

ABSTRACT

Background: The effect of fluid overload and variation on residual renal function (RRF) in peritoneal dialysis (PD) patients is controversial.

Methods: Retrospective cohort study was designed. One-hundred and ninety PD patients with measured glomerular filtration rate (mGFR) ≧ 3 ml/min/1.73 m2 were recruit. Fluid status of every participant was assessed by bioelectrical impedance analysis (BIA) every 3 months for 1 year. The cohort was divided into three hydration groups, namely persistent overhydration (PO) group, intermittent overhydration (IO) group and normal hydration (NH) group. Additionally, participants were also divided into high or low fluid variation groups. The decline rate of RRF and the event of anuria were followed up for 1 year. The association of fluid overload with RRF loss was evaluated by Cox proportional hazard models adjusted for confounders.

Results: Thirty-six (18.9%) patients developed anuria. The decline rate of mGFR in both PO and IO groups were significantly faster than that of NH group (PO vs NH: -0.2 vs -0.1 ml/min/1.73 m2/month, p < 0.01; IO vs NH: -0.2 vs -0.1 ml/min/1.73 m2/month, p < 0.01). Kaplan-Meier analysis showed poorer RRF outcome in both PO and IO groups compared with that of NH group (PO vs NH: p < 0.001; IO vs NH: p = 0.006). Patients with high fluid variation had worse RRF survival than those with low fluid variation (p = 0.04). Adjusted Cox regression models indicated the hazard ratio of RRF loss in PO group was 8.90-folds higher (95% confidence interval 3.07-31.89) than that in NH group.

Conclusions: These findings suggested fluid overload was independently associated with the decline of RRF in PD patients.

Show MeSH
Related in: MedlinePlus