Gender impact on baseline peritoneal transport properties in incident peritoneal dialysis patients.

OBJECTIVE

To explore the impact of gender on baseline peritoneal transportation properties and ultrafiltration (UF) ability.

METHOD

Patients who started peritoneal dialysis (PD) in our PD center were retrospectively analyzed. Peritoneal transportation characteristics and other UF-associated factors were compared between male and female patients. Stepwise linear regression analysis and propensity score (PS) analysis were used to identify the predictors of peritoneal equilibration test (PET) UF.

RESULTS

A total of 1052 patients (424 women and 628 men) were included. Compared with male PD patients, females were older (48.4 ± 15.3 vs 46.0 ± 14.6 years), with less total body water (27.6 ± 2.5 vs 36.9 ± 3.8 L), lower body mass index (21.2 ± 3.4 vs 22.0 ± 2.9 kg/m), lower albumin levels (37.4 ± 5.2 vs 38.0 ± 5.4 g/L), worse renal function [residual glomerular filtration rate: 2.6 (1.2, 3.9) vs 3.2 (1.8, 5.5) mL/min/1.73 m], lower dialysate-to-plasma ratio of creatinine at 4-h PET (D/PCr; 0.68 ± 0.11 vs 0.72 ± 0.12), higher 4-h effluent glucose level/0-h effluent glucose level of PET (D4/D0; 0.41 ± 0.08 vs 0.38 ± 0.08), better UF ability [PET UF: 320 (200, 400) vs 260 (150, 360) mL], and higher Kt/V (2.66 ± 0.60 vs 2.23 ± 0.66) (all P < 0.05) when starting PD. Stepwise linear regression analysis showed that D4/D0, residual urine output, D/PCr, and gender are independently associated with PET UF. By propensity score analysis, female patients still showed significantly more PET UF than male counterparts even with balanced D/PCr, D4/D0, and residual urine.

CONCLUSION

Among the new PD patients, females showed much higher D4/D0, lower D/PCr, and more PET UF than males, with better PET UF being independent of slower solute transportation.