Hypoalbuminemia, Poor Calcium-Phosphorus Control and High Transporter Peritoneal Characteristics - Three Important 10-Year Survival Predictors for Peritoneal Dialysis Patients

Abstract

OBJECTIVE: Peritoneal transport characteristic is a potential survival predictor. In this study we evaluated the effect of transport characteristics on 10 year patient survival and compared its' impact with other possible survival predictors.

MATERIAL and METHODS: We included 75 CAPD patients who were followed in our center for at least 10 years after initiation of PD. Based on the standard peritoneal equilibration test, PD patients were divided into two transporter groups: Low / Low average (n: 27) and High / High Average (n: 48). Clinical and demographic data were collected from patient charts and impact of transporter characteristics and some other well-known survival predictors were studied.

RESULTS: 10 year PD survival rates were significantly lower in H/HA group (p: 0.001). Atherosclerosis-related mortality rate was significantly higher in H/HA group (45.9% vs. 7.6%, p: 0.043). Hypoalbuminemia, increased CaxP, chronic inflammation, H/HA transport status were independent predictors of PD and patient survival. Further analysis revealed that hypoalbuminemia (p: 0.0001) and increased CaxP levels (p: 0.0001) were the main predictors.

CONCLUSION: This study suggests that peritoneal transport status is an important survival predictor. However keeping the calcium and phosphorus levels in recommended ranges, and improving nutritional status still have more importance for lowering mortality rates of PD patients.