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The effect of dialytic modalities on clinical outcomes in ESRD patients with familial Mediterranean fever.
Ren Fail. 2007; 29(3):315-9.RF

Abstract

BACKGROUND

Familial Mediterranean fever (FMF) is an autosomal recessive disease seen primarily in Sephardic Jews, Turks, and Armenians. The disease manifests as recurrent attacks of fever and serositis. The most important complication of FMF is the development of renal failure due to AA type amyloidosis. There has not been extensive experience with renal replacement therapy in FMF amyloidosis. Nevertheless, there may be a concern about the possibility of higher rates of morbidity and mortality in amyloidotic patients maintained on chronic hemodialysis. Moreover, there is not enough experience regarding patients on chronic peritoneal dialysis. As a result, the best treatment modality of end-stage renal disease (ESRD) in these circumstances still remains unclear. This study aimed to compare the effect of hemodialysis and peritoneal dialysis modalities on clinical outcomes in ESRD patients associated with FMF amyloidosis.

METHODS

Forty FMF patients with ESRD due to amyloidosis were retrospectively analyzed. All 40 patients were on renal replacement therapy, 20 on hemodialysis (HD), 20 on peritoneal dialysis (PD). Peritoneal solute transport rates, weekly mean creatinine clearance, and daily mean ultrafiltration (UF) of the patients on chronic peritoneal dialysis were evaluated. Weekly dialysis durations, dialysis membrane properties, Kt/V values, interdialytic weight gains, and frequency of hypotension during dialysis were evaluated on hemodialysis patients. All of the patients were examined according to their demographic characteristics, laboratory results, duration time on dialysis, erythropoietin requirements, frequencies of infectious complications requiring hospitalization, and the two renal replacement modalities mentioned above were compared in terms of these parameters.

RESULTS

Serum albumin levels of the patients with FMF amyloidosis who were maintained on peritoneal dialysis treatment were lower (2.87 vs 3.45) and the frequency of infections of the same group was higher (4.2 vs 0.5) than the patients with ESRD secondary to other diseases in the CAPD group.

CONCLUSIONS

This retrospective analysis showed that peritoneal dialysis may have some disadvantages in amyloidotic patients. Due to the high frequency of hypoalbuminemia and infectious complications seen in this group, peritoneal dialysis is widely accepted as an alternative choice of treatment when hemodialysis is not appropriate.

Authors+Show Affiliations

Division of Nephrology, Goztepe Research and Training Hospital, Istanbul, Turkey.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17497446

Citation

Sahin, Sevgi, et al. "The Effect of Dialytic Modalities On Clinical Outcomes in ESRD Patients With Familial Mediterranean Fever." Renal Failure, vol. 29, no. 3, 2007, pp. 315-9.
Sahin S, Sahin GM, Ergin H, et al. The effect of dialytic modalities on clinical outcomes in ESRD patients with familial Mediterranean fever. Ren Fail. 2007;29(3):315-9.
Sahin, S., Sahin, G. M., Ergin, H., & Kantarci, G. (2007). The effect of dialytic modalities on clinical outcomes in ESRD patients with familial Mediterranean fever. Renal Failure, 29(3), 315-9.
Sahin S, et al. The Effect of Dialytic Modalities On Clinical Outcomes in ESRD Patients With Familial Mediterranean Fever. Ren Fail. 2007;29(3):315-9. PubMed PMID: 17497446.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of dialytic modalities on clinical outcomes in ESRD patients with familial Mediterranean fever. AU - Sahin,Sevgi, AU - Sahin,Gulizar Manga, AU - Ergin,Hulya, AU - Kantarci,Gulcin, PY - 2007/5/15/pubmed PY - 2008/4/5/medline PY - 2007/5/15/entrez SP - 315 EP - 9 JF - Renal failure JO - Ren Fail VL - 29 IS - 3 N2 - BACKGROUND: Familial Mediterranean fever (FMF) is an autosomal recessive disease seen primarily in Sephardic Jews, Turks, and Armenians. The disease manifests as recurrent attacks of fever and serositis. The most important complication of FMF is the development of renal failure due to AA type amyloidosis. There has not been extensive experience with renal replacement therapy in FMF amyloidosis. Nevertheless, there may be a concern about the possibility of higher rates of morbidity and mortality in amyloidotic patients maintained on chronic hemodialysis. Moreover, there is not enough experience regarding patients on chronic peritoneal dialysis. As a result, the best treatment modality of end-stage renal disease (ESRD) in these circumstances still remains unclear. This study aimed to compare the effect of hemodialysis and peritoneal dialysis modalities on clinical outcomes in ESRD patients associated with FMF amyloidosis. METHODS: Forty FMF patients with ESRD due to amyloidosis were retrospectively analyzed. All 40 patients were on renal replacement therapy, 20 on hemodialysis (HD), 20 on peritoneal dialysis (PD). Peritoneal solute transport rates, weekly mean creatinine clearance, and daily mean ultrafiltration (UF) of the patients on chronic peritoneal dialysis were evaluated. Weekly dialysis durations, dialysis membrane properties, Kt/V values, interdialytic weight gains, and frequency of hypotension during dialysis were evaluated on hemodialysis patients. All of the patients were examined according to their demographic characteristics, laboratory results, duration time on dialysis, erythropoietin requirements, frequencies of infectious complications requiring hospitalization, and the two renal replacement modalities mentioned above were compared in terms of these parameters. RESULTS: Serum albumin levels of the patients with FMF amyloidosis who were maintained on peritoneal dialysis treatment were lower (2.87 vs 3.45) and the frequency of infections of the same group was higher (4.2 vs 0.5) than the patients with ESRD secondary to other diseases in the CAPD group. CONCLUSIONS: This retrospective analysis showed that peritoneal dialysis may have some disadvantages in amyloidotic patients. Due to the high frequency of hypoalbuminemia and infectious complications seen in this group, peritoneal dialysis is widely accepted as an alternative choice of treatment when hemodialysis is not appropriate. SN - 0886-022X UR - https://www.unboundmedicine.com/medline/citation/17497446/The_effect_of_dialytic_modalities_on_clinical_outcomes_in_ESRD_patients_with_familial_Mediterranean_fever_ L2 - http://www.tandfonline.com/doi/full/10.1080/08860220601166560 DB - PRIME DP - Unbound Medicine ER -