[Low level of residual renal function in the initial month and high transport characteristic as important causes of peritoneal dialysis failure].

OBJECTIVE

To evaluate what kind of patients was at high risk on peritoneal dialysis (PD) treatment.

METHODS

96 patients on PD for (23.1 +/- 10.0) months were studied. The patients were divided into two groups. Group A: patients (25) who died or switched to hemodialysis because of cardiovascular disease, malnutrition, ultrafiltration inefficiency, hydrothora, relapsing peritonitis, etc. Group B: stable PD patients (71) up to now. Age, body surface area (BSA) and dialysate fill volume (DV) were not different between the two groups. The nutritional status, dialysis adequacy, peritoneal membrane transport characteristics, and residual renal function (RRF) in the initial month of dialysis were compared. Patient survival rate was studied by Kaplan-Meier method.

RESULTS

It was demonstrated that Kt/V and Ccr in group A were lower than those in group B (P < 0.05). Meanwhile, RRF was significantly different between the two groups; patients with better RRF (> or = 2 ml/min) had higher survival. The percentage of high transporters in group A was greater than in group B.

CONCLUSION

Higher clearance in the initial month of dialysis seems to keep PD successful. PD failure maybe related to high transport characteristic and its treatment modality is DAPD. Hemodialysis will be a better choice when RRF is very low as water balance is poorly controlled by DAPD.