The Factors Influencing Peritoneal Membrane Transport Characteristics Within 4 Weeks in CAPD Patients / 대한신장학회잡지

ABSTRACT

BACKGROUND: To get stability and reproducibility of peritoneal membrane transport characteristics of peritoneal dialysis patients, peritoneal equilibration test (PET) is usually recommended at least 1 month after initiation of peritoneal dialysis. But there has been controversy about the exact mechanism. The aim of this study was to compare peritoneal membrane transport characteristics at 2nd and 4th week after initiation of peritoneal dialysis and analyze associated factors. METHODS: From May 2001 to March 2002, 60 new CAPD patients in our hospital were enrolled (male 31, mean age 52.6 years old, DM 23). PET, body weight, body surface area (BSA), blood hemoglobin, serum albumin, hs-CRP(high sensitivity C reactive protein), 24 hours dialysate volume and 24 hours dialysate albumin amount, weekly Kt/Vurea, weekly CCr, residual renal function (RRF) were checked at 2nd and 4th week. Paired t-test, independent t-test, Pearson correlation and multiple regression analysis (GEE by STATA, version 7.0) were used. RESULTS: We can summarize the RESULTS: D/P4Cr and hemoglobin level were significantly increased with time (0.66+/-0.13 g/dL vs. 0.69+/-0.11 g/dL and 9.38+/-1.12 g/dL vs. 9.82+/-1.09 g/dL, p<0.05, respectively) and body weight was significantly decreased with time (63.1+/-11.7 kg vs. 62.4+/-11.2 kg, p<0.05). Factors influencing D/P4Cr change were 24 hours dialysate volume, serum albumin and 24 hours dialysate albumin amount (Beta coefficients -0.044/L, -0.062/g/dL and 0.028/g/day, p<0.01, respectively). Factors influencing serum albumin (g/dL) were D/ P4Cr, 24 hours dialysate volume and hemoglobin level (Beta coefficients -0.129/0.1, -0.117/L and 0.133/g/ dL, p<0.01, respectively). There was positive correlation between delta changes of D/P4Cr and delta changes of hs CRP (r=0.297, p=0.02) CONCLUSION: The change of D/P4Cr within 1 month was reciprocally correlated with the change of serum albumin (negatively) and hs CRP (positively). The change of serum albumin, 24 hours dialysate volume and 24 hours albumin loss via dialysate influenced the change of D/P4Cr within 1 month after initiation of peritoneal dialysis.