The clinical courses in stable CAPD patients

Choi, Jun Heuk; Kim, Dong Han; Kim, Jeong Mi; Lee, Sang Won; Park, Jong Won; Do, Jun Young; Yoon, Kyung Woo

Abstract

BACKGROUND: Continuous ambulatory peritoneal dialysis (CAPD) has become firmly established as an effective mode of renal replacement therapy. The purpose of this study was to understand the clinical courses in stable CAPD patients.
METHODS
Fifty-four patients were analyzed with residual renal function (RRF), adequacy of dialysis (such as weekly Kt/V), urine volume, normalized protein catabolic rate (nPCR), serum albumin and dialysate CA125. We retrospectively compared the changes of several indices at mean 5.8 months and mean 31.3 months after initiation of CAPD.
RESULTS
During CAPD, body weight was significantly increased (59.6+/-10.9 vs. 62.7+/-10.6 kg, p < 0.01: 2.9 kg/year) but RRF (2.61+/-2.78 vs. 2.02+/-2.73 mL/min, p < 0.05) were significantly decreased with time. Higher RRF group showed higher nPCR (1.07+/-0.36 vs. 0.89+/-0.15 g/kg/day, p < 0.01) and higher weekly Kt/V (2.49+/-0.66 vs. 1.97+/-0.40, p < 0.01). DM group showed lower dialysate CA125 (17.34+/-6.83 vs. 28.03+/-19.08 U/mL, p < 0.05) and lower serum albumin. From the beginning, hypoalbuminemic patients showed higher 4hr (D/P)Cr (0.68+/-0.11 vs. 0.59+/-0.12, p < 0.05). Serum albumin was negatively correlated with 4hr (D/P)Cr (r=-0.308, p=0.008).
CONCLUSION
Stable CAPD patients showed weight gain and decrement of RRF with time. And better RRF group showed better clinical indices (nPCR, wKt/V). We can conclude that maintaining of RRF will be important to keep better clinical courses of CAPD patients. Further study (including effect of peritonitis) will be necessary to evaluate the clinical courses of CAPD patients.