Risk factors of high peritoneal transport characteristics in initial peritoneal dialysis patients_West China Medical Journal

Authors：

TANG Jing ^1,2 , FU Ping ¹ ,  ZHONG Hui ¹

1. Division of Nephrology, Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Division of Nephrology, Pangang Group General Hospital, Panzhihua, Sichuan 617000, P. R. China;

Corresponding author：

ZHONG Hui, Email: zhonghui39@126.com

Keywords：

Initial peritoneal dialysis; High peritoneal transport characteristics; Body surface area; Serum albumin; Uric acid; Risk factors

DOI：

10.7507/1002-0179.201912239

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the risk factors of high peritoneal transport characteristics in patients with end-stage renal disease undergoing initial continuous ambulatory peritoneal dialysis. Method The clinical data of continuous ambulatory peritoneal dialysis patients who underwent initial peritoneal dialysis and catheterization in the Department of Nephrology, West China Hospital of Sichuan University from January 2011 to December 2017 and completed the peritoneal equilibration test were collected retrospectively. According to the ratio of dialysate to plasma ratio for creatinine at 4 hour [D/Pcr (4h)] in the standard peritoneal equilibration test, the patients were divided into 4 groups (low transport, low average transport, high average transport and high transport). Spearman correlation analysis was used to analyze the related factors of D/Pcr (4h). The risk factors of high peritoneal transport characteristics were analyzed by ordered multi classification logistic regression. Results A total of 647 patients were included. The average age of the patients was (45.85±14.03) years, and the average D/Pcr (4h) was 0.67±0.12. Among them, there were 89 cases (13.76%) in the high transport group, 280 cases (43.28%) in the high average transport group, 234 cases (36.17%) in the low average transport group and 44 cases (6.80%) in the low transport group. Diabetic patients with D/Pcr (4h) were higher than those without diabetes mellitus (0.72±0.12 vs. 0.66±0.12; t=−4.005, P<0.001). Correlation analysis showed that age and 24-h urine volume were positively correlated with D/Pcr (4h); serum albumin, triglyceride, potassium, calcium, magnesium, phosphorus, hemoglobin, serum uric acid and creatinine were negatively correlated with D/Pcr (4h); body surface area (BSA), high sensitivity C-reactive protein, ferritin, cholesterol, sodium, intact parathyroid hormone and estimated giomerular filtration rate had no correlation with D/Pcr (4h). Regression analysis showed that serum albumin [odds ratio (OR)=0.842, 95% confidence interval (CI) (0.809, 0.877), P<0.001], serum uric acid [OR=0.996, 95%CI (0.994, 0.998), P<0.001], magnesium [OR=0.389, 95%CI (0.156, 0.965), P=0.042], BSA [OR=3.916, 95%CI (1.121, 13.680), P=0.032] were correlated with the incidence of peritoneal high transport characteristics. Conclusion Low serum albumin, high BSA, low magnesium and low serum uric acid were independent risk factors for high transport characteristics in initial PD patients.

Citation： TANG Jing, FU Ping, ZHONG Hui. Risk factors of high peritoneal transport characteristics in initial peritoneal dialysis patients. West China Medical Journal, 2021, 36(11): 1556-1562. doi: 10.7507/1002-0179.201912239 Copy

1.	Wang H, Tian J, Du F, et al. Effect of peritoneal transport characteristics on clinical outcome in nondiabetic and diabetic nephropathy patients with peritoneal dialysis. Iran J Kidney Dis, 2019, 13(1): 56-66.
2.	Yoowannakul S, Harris LS, Davenport A. Peritoneal protein losses depend on more than just peritoneal dialysis modality and peritoneal membrane transporter status. Ther Apher Dial, 2018, 22(2): 171-177.
3.	Davies SJ. Longitudinal relationship between solute transport and ultrafiltration capacity in peritoneal dialysis patients. Kidney Int, 2004, 66(6): 2437-2445.
4.	Fernandes A, Ribera-Sanchez R, Rodríguez-Carmona A, et al. Peritoneal water transport characteristics of diabetic patients undergoing peritoneal dialysis: a longitudinal study. Am J Nephrol, 2017, 46(1): 47-54.
5.	Chung SH, Chu WS, Lee HA, et al. Peritoneal transport characteristics, comorbid diseases and survival in CAPD patients. Perit Dial Int, 2000, 20(5): 541-547.
6.	Brimble KS, Walker M, Margetts PJ, et al. Meta-analysis: peritoneal membrane transport, mortality, and technique failure in peritoneal dialysis. J Am Soc Nephrol, 2006, 17(9): 2591-2598.
7.	蒋静, 钟慧, 秦敏, 等. 初始腹膜高转运特性与腹膜透析患者预后的关系. 华西医学, 2019, 34(7): 752-758.
8.	Rumpsfeld M, McDonald SP, Johnson DW. Higher peritoneal transport status is associated with higher mortality and technique failure in the Australian and New Zealand peritoneal dialysis patient populations. J Am Soc Nephrol, 2006, 17(1): 271-278.
9.	Twardowski Z, Nolph K, Khanna R. Peritoneal equilibration test. Perit Dial Bull, 1987, 7(3): 138-147.
10.	陈香美, 倪兆慧, 付平, 等. 腹膜透析标准操作规程. 北京: 人民军医出版社, 2012: 96-98.
11.	Ates K, Ertürk S, Nergisoglu G, et al. Sex-dependent variations in peritoneal membrane transport properties in CAPD patients. Nephrol Dial Transplant, 1996, 11(11): 2375-2376.
12.	Fan J, Guo Q, Zhou Q, et al. Gender impact on baseline peritoneal transport properties in incident peritoneal dialysis patients. Int Urol Nephrol, 2019, 51(11): 2055-2061.
13.	Armoni M, Rafaeloff R, Barzilai A, et al. Sex differences in insulin action on glucose transport and transporters in human omental adipocytes. J Clin Endocrinol Metab, 1987, 65(6): 1141-1146.
14.	Nakamoto H, Imai H, Kawanishi H, et al. Low serum albumin in elderly continuous ambulatory peritoneal dialysis patients is attributable to high permeability of peritoneum. Adv Perit Dial, 2001, 17: 238-243.
15.	Unal A, Sipahioglu M. H, Kocyigit I, et al. Risk factor(s) related to high membrane permeability in peritoneal dialysis. Ren Fail, 2016, 38(2): 238-241.
16.	Dobbie JW. Monitoring peritoneal histopathology in peritoneal dialysis: the role of a biopsy registry. Dial Transplant, 1989, 18: 319-325.
17.	Contreras-Velázquez JC, Soto V, Jaramillo-Rodríguez Y, et al. Clinical outcomes and peritoneal histology in patients starting peritoneal dialysis are related to diabetic status and serum albumin levels. Kidney Int Suppl, 2008, 73(108): S34-S41.
18.	Davenport A, Willicombe MK. Does diabetes mellitus predispose to increased fluid overload in peritoneal dialysis patients?. Nephron Clin Pract, 2010, 114(1): c60-c66.
19.	Chou MY, Kao MT, Lai MN, et al. Comparisons of the peritoneal equilibration test and ultrafiltration in patients with and without diabetes mellitus on continuous ambulatory peritoneal dialysis. Am J Nephrol, 2006, 26(1): 87-90.
20.	Koçak G, Azak A, Astarcı HM, et al. Effects of renin-angiotensin-aldosterone system blockade on chlorhexidine gluconate-induced sclerosing encapsulated peritonitis in rats. Ther Apher Dial, 2012, 16(1): 75-80.
21.	Duman S, Sen S, Duman C, et al. Effect of valsartan versus lisinopril on peritoneal sclerosis in rats. Int J Artif Organs, 2005, 28(2): 156-163.
22.	Io H, Hamada C, Ro Y, et al. Morphologic changes of peritoneum and expression of VEGF in encapsulated peritoneal sclerosis rat models. Kidney Int, 2004, 65(5): 1927-1936.
23.	Kariya T, Nishimura H, Mizuno M, et al. TGF-β1-VEGF-A pathway induces neoangiogenesis with peritoneal fibrosis in patients undergoing peritoneal dialysis. Am J Physiol Renal Physiol, 2018, 314(2): F167-F180.
24.	Wontanatawatot W, Eiam-Ong S, Leelahavanichkul A, et al. An update on RAAS blockade and peritoneal membrane preservation: the ace of art. J Med Assoc Thai, 2011, 94(Suppl 4): S175-S183.
25.	Trošt Rupnik A, Pajek J, Guček A, et al. Influence of renin-angiotensin-aldosterone system-blocking drugs on peritoneal membrane in peritoneal dialysis patients. Ther Apher Dial, 2013, 17(4): 425-430.
26.	Sauter M, Cohen CD, Wörnle M, et al. ACE inhibitor and AT1-receptor blocker attenuate the production of VEGF in mesothelial cells. Perit Dial Int, 2007, 27(2): 167-172.
27.	Kolesnyk I, Noordzij M, Dekker FW, et al. A positive effect of AII inhibitors on peritoneal membrane function in long-term PD patients. Nephrol Dial Transplant, 2009, 24(1): 272-277.
28.	Imai H, Nakamoto H, Ishida Y, et al. Renin-angiotensin system plays an important role in the regulation of water transport in the peritoneum. Adv Perit Dial, 2001, 17: 20-24.
29.	孙方云, 冉盖, 向思云, 等. 腹膜透析患者腹透液蛋白质丢失及其影响因素分析. 温州医科大学学报, 2015, 45(1): 18-21.
30.	Margetts PJ, McMullin JP, Rabbat CG, et al. Peritoneal membrane transport and hypoalbuminemia: cause or effect?. Perit Dial Int, 2000, 20(1): 14-18.
31.	Harrison R. Structure and function of xanthine oxidoreductase: where are we now?. Free Radic Biol Med, 2002, 33(6): 774-797.
32.	Beberashvili I, Sinuani I, Azar A, et al. Serum uric acid as a clinically useful nutritional marker and predictor of outcome in maintenance hemodialysis patients. Nutrition, 2015, 31(1): 138-147.
33.	Xiao X, Ye H, Yi C, et al. Roles of peritoneal clearance and residual kidney removal in control of uric acid in patients on peritoneal dialysis. BMC Nephrol, 202, 21(1): 148.

1. Wang H, Tian J, Du F, et al. Effect of peritoneal transport characteristics on clinical outcome in nondiabetic and diabetic nephropathy patients with peritoneal dialysis. Iran J Kidney Dis, 2019, 13(1): 56-66.
2. Yoowannakul S, Harris LS, Davenport A. Peritoneal protein losses depend on more than just peritoneal dialysis modality and peritoneal membrane transporter status. Ther Apher Dial, 2018, 22(2): 171-177.
3. Davies SJ. Longitudinal relationship between solute transport and ultrafiltration capacity in peritoneal dialysis patients. Kidney Int, 2004, 66(6): 2437-2445.
4. Fernandes A, Ribera-Sanchez R, Rodríguez-Carmona A, et al. Peritoneal water transport characteristics of diabetic patients undergoing peritoneal dialysis: a longitudinal study. Am J Nephrol, 2017, 46(1): 47-54.
5. Chung SH, Chu WS, Lee HA, et al. Peritoneal transport characteristics, comorbid diseases and survival in CAPD patients. Perit Dial Int, 2000, 20(5): 541-547.
6. Brimble KS, Walker M, Margetts PJ, et al. Meta-analysis: peritoneal membrane transport, mortality, and technique failure in peritoneal dialysis. J Am Soc Nephrol, 2006, 17(9): 2591-2598.
7. 蒋静, 钟慧, 秦敏, 等. 初始腹膜高转运特性与腹膜透析患者预后的关系. 华西医学, 2019, 34(7): 752-758.
8. Rumpsfeld M, McDonald SP, Johnson DW. Higher peritoneal transport status is associated with higher mortality and technique failure in the Australian and New Zealand peritoneal dialysis patient populations. J Am Soc Nephrol, 2006, 17(1): 271-278.
9. Twardowski Z, Nolph K, Khanna R. Peritoneal equilibration test. Perit Dial Bull, 1987, 7(3): 138-147.
10. 陈香美, 倪兆慧, 付平, 等. 腹膜透析标准操作规程. 北京: 人民军医出版社, 2012: 96-98.
11. Ates K, Ertürk S, Nergisoglu G, et al. Sex-dependent variations in peritoneal membrane transport properties in CAPD patients. Nephrol Dial Transplant, 1996, 11(11): 2375-2376.
12. Fan J, Guo Q, Zhou Q, et al. Gender impact on baseline peritoneal transport properties in incident peritoneal dialysis patients. Int Urol Nephrol, 2019, 51(11): 2055-2061.
13. Armoni M, Rafaeloff R, Barzilai A, et al. Sex differences in insulin action on glucose transport and transporters in human omental adipocytes. J Clin Endocrinol Metab, 1987, 65(6): 1141-1146.
14. Nakamoto H, Imai H, Kawanishi H, et al. Low serum albumin in elderly continuous ambulatory peritoneal dialysis patients is attributable to high permeability of peritoneum. Adv Perit Dial, 2001, 17: 238-243.
15. Unal A, Sipahioglu M. H, Kocyigit I, et al. Risk factor(s) related to high membrane permeability in peritoneal dialysis. Ren Fail, 2016, 38(2): 238-241.
16. Dobbie JW. Monitoring peritoneal histopathology in peritoneal dialysis: the role of a biopsy registry. Dial Transplant, 1989, 18: 319-325.
17. Contreras-Velázquez JC, Soto V, Jaramillo-Rodríguez Y, et al. Clinical outcomes and peritoneal histology in patients starting peritoneal dialysis are related to diabetic status and serum albumin levels. Kidney Int Suppl, 2008, 73(108): S34-S41.
18. Davenport A, Willicombe MK. Does diabetes mellitus predispose to increased fluid overload in peritoneal dialysis patients?. Nephron Clin Pract, 2010, 114(1): c60-c66.
19. Chou MY, Kao MT, Lai MN, et al. Comparisons of the peritoneal equilibration test and ultrafiltration in patients with and without diabetes mellitus on continuous ambulatory peritoneal dialysis. Am J Nephrol, 2006, 26(1): 87-90.
20. Koçak G, Azak A, Astarcı HM, et al. Effects of renin-angiotensin-aldosterone system blockade on chlorhexidine gluconate-induced sclerosing encapsulated peritonitis in rats. Ther Apher Dial, 2012, 16(1): 75-80.
21. Duman S, Sen S, Duman C, et al. Effect of valsartan versus lisinopril on peritoneal sclerosis in rats. Int J Artif Organs, 2005, 28(2): 156-163.
22. Io H, Hamada C, Ro Y, et al. Morphologic changes of peritoneum and expression of VEGF in encapsulated peritoneal sclerosis rat models. Kidney Int, 2004, 65(5): 1927-1936.
23. Kariya T, Nishimura H, Mizuno M, et al. TGF-β1-VEGF-A pathway induces neoangiogenesis with peritoneal fibrosis in patients undergoing peritoneal dialysis. Am J Physiol Renal Physiol, 2018, 314(2): F167-F180.
24. Wontanatawatot W, Eiam-Ong S, Leelahavanichkul A, et al. An update on RAAS blockade and peritoneal membrane preservation: the ace of art. J Med Assoc Thai, 2011, 94(Suppl 4): S175-S183.
25. Trošt Rupnik A, Pajek J, Guček A, et al. Influence of renin-angiotensin-aldosterone system-blocking drugs on peritoneal membrane in peritoneal dialysis patients. Ther Apher Dial, 2013, 17(4): 425-430.
26. Sauter M, Cohen CD, Wörnle M, et al. ACE inhibitor and AT1-receptor blocker attenuate the production of VEGF in mesothelial cells. Perit Dial Int, 2007, 27(2): 167-172.
27. Kolesnyk I, Noordzij M, Dekker FW, et al. A positive effect of AII inhibitors on peritoneal membrane function in long-term PD patients. Nephrol Dial Transplant, 2009, 24(1): 272-277.
28. Imai H, Nakamoto H, Ishida Y, et al. Renin-angiotensin system plays an important role in the regulation of water transport in the peritoneum. Adv Perit Dial, 2001, 17: 20-24.
29. 孙方云, 冉盖, 向思云, 等. 腹膜透析患者腹透液蛋白质丢失及其影响因素分析. 温州医科大学学报, 2015, 45(1): 18-21.
30. Margetts PJ, McMullin JP, Rabbat CG, et al. Peritoneal membrane transport and hypoalbuminemia: cause or effect?. Perit Dial Int, 2000, 20(1): 14-18.
31. Harrison R. Structure and function of xanthine oxidoreductase: where are we now?. Free Radic Biol Med, 2002, 33(6): 774-797.
32. Beberashvili I, Sinuani I, Azar A, et al. Serum uric acid as a clinically useful nutritional marker and predictor of outcome in maintenance hemodialysis patients. Nutrition, 2015, 31(1): 138-147.
33. Xiao X, Ye H, Yi C, et al. Roles of peritoneal clearance and residual kidney removal in control of uric acid in patients on peritoneal dialysis. BMC Nephrol, 202, 21(1): 148.

West China Medical Journal

Risk factors of high peritoneal transport characteristics in initial peritoneal dialysis patients

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content