Peritoneal equilibration test and patient outcomes

Rajnish Mehrotra, Vanessa Ravel, Elani Streja, Sooraj Kuttykrishnan, Scott V. Adams, Ronit Katz, M. Molnár, Kamyar Kalantar-Zadeh

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background and objectives Although a peritoneal equilibration test yields data on three parameters (4-hour dialysate/plasma creatinine, 4-to 0-hour dialysate glucose, and 4-hour ultrafiltration volume), all studies have focused on the prognostic value of dialysate/plasma creatinine for patients undergoing peritoneal dialysis. Because dialysate 4-to 0-hour glucose and ultrafiltration volume may be superior in predicting daily ultrafiltration, the likelymechanismfor the association of peritoneal equilibration test results with outcomes, we hypothesized that they are superior to dialysate/plasma creatinine for risk prediction. Design, setting, participants, & measurements We examined unadjusted and adjusted associations of three peritoneal equilibration test parameters with all-cause mortality, technique failure, and hospitalization rate in 10,142 patients on peritoneal dialysis treated between January 1, 2007 and December 31, 2011 in 764 dialysis facilities operated by a single large dialysis organization in the United States, with amedian follow-up period of 15.8 months; 87% were treated with automated peritoneal dialysis. ResultsDemographic and clinical parameters explained only 8% of the variability in dialysate/plasma creatinine. There was a linear association between dialysate/plasma creatinine and mortality (adjusted hazards ratio per 0.1 unit higher, 1.07; 95% confidence interval, 1.02 to 1.13) and hospitalization rate (adjusted incidence rate ratio per 0.1 unit higher, 1.05; 95% confidence interval, 1.03 to 1.06). Dialysate/plasma creatinine and dialysate glucose were highly correlated (r=20.84) and yielded similar risk prediction. Ultrafiltration volume was inversely related with hospitalization rate but not with all-cause mortality. None of the parameters were associated with technique failure. Adding 4-to 0-hour dialysate glucose, ultrafiltration volume, or both did not result in any improvement in risk prediction with dialysate/plasma creatinine alone. Conclusions This analysis from a large contemporary cohort treated primarily with automated peritoneal dialysis validates dialysate/plasma creatinine as a robust predictor of outcomes in patients treated with peritoneal dialysis.

Original languageEnglish
Pages (from-to)1990-2001
Number of pages12
JournalClinical Journal of the American Society of Nephrology
Volume10
Issue number11
DOIs
Publication statusPublished - Nov 6 2015

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Dialysis Solutions
Creatinine
Ultrafiltration
Peritoneal Dialysis
Glucose
Hospitalization
Mortality
Dialysis
Confidence Intervals
Organizations

ASJC Scopus subject areas

  • Nephrology
  • Transplantation
  • Epidemiology
  • Critical Care and Intensive Care Medicine

Cite this

Mehrotra, R., Ravel, V., Streja, E., Kuttykrishnan, S., Adams, S. V., Katz, R., ... Kalantar-Zadeh, K. (2015). Peritoneal equilibration test and patient outcomes. Clinical Journal of the American Society of Nephrology, 10(11), 1990-2001. https://doi.org/10.2215/CJN.03470315

Peritoneal equilibration test and patient outcomes. / Mehrotra, Rajnish; Ravel, Vanessa; Streja, Elani; Kuttykrishnan, Sooraj; Adams, Scott V.; Katz, Ronit; Molnár, M.; Kalantar-Zadeh, Kamyar.

In: Clinical Journal of the American Society of Nephrology, Vol. 10, No. 11, 06.11.2015, p. 1990-2001.

Research output: Contribution to journalArticle

Mehrotra, R, Ravel, V, Streja, E, Kuttykrishnan, S, Adams, SV, Katz, R, Molnár, M & Kalantar-Zadeh, K 2015, 'Peritoneal equilibration test and patient outcomes', Clinical Journal of the American Society of Nephrology, vol. 10, no. 11, pp. 1990-2001. https://doi.org/10.2215/CJN.03470315
Mehrotra R, Ravel V, Streja E, Kuttykrishnan S, Adams SV, Katz R et al. Peritoneal equilibration test and patient outcomes. Clinical Journal of the American Society of Nephrology. 2015 Nov 6;10(11):1990-2001. https://doi.org/10.2215/CJN.03470315
Mehrotra, Rajnish ; Ravel, Vanessa ; Streja, Elani ; Kuttykrishnan, Sooraj ; Adams, Scott V. ; Katz, Ronit ; Molnár, M. ; Kalantar-Zadeh, Kamyar. / Peritoneal equilibration test and patient outcomes. In: Clinical Journal of the American Society of Nephrology. 2015 ; Vol. 10, No. 11. pp. 1990-2001.
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