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The impact of increasing the daytime dialysis exchange frequency on peritoneal dialysis adequacy and nutritional status of Chinese anuric patients.
Perit Dial Int 2002 Mar-Apr; 22(2):197-203PD

Abstract

OBJECTIVE

To study the effect of increasing the daytime dialysis exchange frequency on dialysis adequacy and nutritional status of Chinese anuric patients.

SETTING

University teaching hospital.

PATIENT

100 anuric patients on continuous ambulatory peritoneal dialysis (CAPD).

DESIGN

50 patients had one additional daytime 2-L exchange (intervention group); the dialysis regimen remained unchanged in the other 50 patients (control group).

OUTCOME

Dialysis adequacy [Kt/V, weekly creatinine clearance (wCCr), and net ultrafiltration (UF)] and nutritional status [serum albumin, dietary protein intake, represented by normalized protein nitrogen appearance (nPNA), and percent lean body mass (%LBM)] were measured at 0 and 6 months.

RESULTS

Baseline dialysis adequacy and nutritional indices were comparable between the two groups. In the control group, all parameters remained stable at month 6. In the intervention group, there were significant increases in UF, Kt/V, wCCr, nPNA, and %LBM from months 0 to 6. The improvement in nPNA was affected by daily exchange volume. In 30 patients, the number of exchanges was increased from 3 to 4 per day; their Kt/V and nPNA rose significantly from month 0 to month 6. In the other 20 patients, the number of exchanges was increased from 4 to 5 per day; there was a significant increase in Kt/V but nPNA remained static. The change in nPNA correlated inversely with Kt/V at month 0 (Pearson's r = -0.352, p = 0.012). Multivariate analysis with a general linear model showed that age, Kt/V at month 0, and 3 dialysis exchanges per day at month 0 (versus 4 exchanges) were independent predictors of the change in nPNA.

CONCLUSIONS

Increasing the number of peritoneal dialysis exchanges effectively increased Kt/V in Chinese anuric CAPD patients. However, the improvement in nPNA correlated inversely with baseline Kt/V. Although increasing the number of exchanges from 3 to 4 per day improved nPNA, increasing the number of daily exchanges beyond 4 may not improve nPNA further.

Authors+Show Affiliations

Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin. ccszeto@cuhk.edu.hkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11990404

Citation

Szeto, Cheuk-Chun, et al. "The Impact of Increasing the Daytime Dialysis Exchange Frequency On Peritoneal Dialysis Adequacy and Nutritional Status of Chinese Anuric Patients." Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis, vol. 22, no. 2, 2002, pp. 197-203.
Szeto CC, Wong TY, Chow KM, et al. The impact of increasing the daytime dialysis exchange frequency on peritoneal dialysis adequacy and nutritional status of Chinese anuric patients. Perit Dial Int. 2002;22(2):197-203.
Szeto, C. C., Wong, T. Y., Chow, K. M., Leung, C. B., Wang, A. Y., Lui, S. F., & Li, P. K. (2002). The impact of increasing the daytime dialysis exchange frequency on peritoneal dialysis adequacy and nutritional status of Chinese anuric patients. Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis, 22(2), pp. 197-203.
Szeto CC, et al. The Impact of Increasing the Daytime Dialysis Exchange Frequency On Peritoneal Dialysis Adequacy and Nutritional Status of Chinese Anuric Patients. Perit Dial Int. 2002;22(2):197-203. PubMed PMID: 11990404.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact of increasing the daytime dialysis exchange frequency on peritoneal dialysis adequacy and nutritional status of Chinese anuric patients. AU - Szeto,Cheuk-Chun, AU - Wong,Teresa Yuk-Hwa, AU - Chow,Kai-Ming, AU - Leung,Chi-Bon, AU - Wang,Angela Yee-Moon, AU - Lui,Siu-Fai, AU - Li,Philip Kam-Tao, PY - 2002/5/7/pubmed PY - 2002/10/31/medline PY - 2002/5/7/entrez SP - 197 EP - 203 JF - Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis JO - Perit Dial Int VL - 22 IS - 2 N2 - OBJECTIVE: To study the effect of increasing the daytime dialysis exchange frequency on dialysis adequacy and nutritional status of Chinese anuric patients. SETTING: University teaching hospital. PATIENT: 100 anuric patients on continuous ambulatory peritoneal dialysis (CAPD). DESIGN: 50 patients had one additional daytime 2-L exchange (intervention group); the dialysis regimen remained unchanged in the other 50 patients (control group). OUTCOME: Dialysis adequacy [Kt/V, weekly creatinine clearance (wCCr), and net ultrafiltration (UF)] and nutritional status [serum albumin, dietary protein intake, represented by normalized protein nitrogen appearance (nPNA), and percent lean body mass (%LBM)] were measured at 0 and 6 months. RESULTS: Baseline dialysis adequacy and nutritional indices were comparable between the two groups. In the control group, all parameters remained stable at month 6. In the intervention group, there were significant increases in UF, Kt/V, wCCr, nPNA, and %LBM from months 0 to 6. The improvement in nPNA was affected by daily exchange volume. In 30 patients, the number of exchanges was increased from 3 to 4 per day; their Kt/V and nPNA rose significantly from month 0 to month 6. In the other 20 patients, the number of exchanges was increased from 4 to 5 per day; there was a significant increase in Kt/V but nPNA remained static. The change in nPNA correlated inversely with Kt/V at month 0 (Pearson's r = -0.352, p = 0.012). Multivariate analysis with a general linear model showed that age, Kt/V at month 0, and 3 dialysis exchanges per day at month 0 (versus 4 exchanges) were independent predictors of the change in nPNA. CONCLUSIONS: Increasing the number of peritoneal dialysis exchanges effectively increased Kt/V in Chinese anuric CAPD patients. However, the improvement in nPNA correlated inversely with baseline Kt/V. Although increasing the number of exchanges from 3 to 4 per day improved nPNA, increasing the number of daily exchanges beyond 4 may not improve nPNA further. SN - 0896-8608 UR - https://www.unboundmedicine.com/medline/citation/11990404/The_impact_of_increasing_the_daytime_dialysis_exchange_frequency_on_peritoneal_dialysis_adequacy_and_nutritional_status_of_Chinese_anuric_patients_ L2 - http://www.pdiconnect.com/cgi/pmidlookup?view=long&pmid=11990404 DB - PRIME DP - Unbound Medicine ER -