Rate of decline in residual kidney function pre and post peritoneal dialysis initiation: A post hoc analysis of the IDEAL study

PloS One
Isabelle EthierDavid W Johnson

Abstract

Residual kidney function (RKF) is associated with improved survival and quality of life in dialysis patients. Previous studies have suggested that initiation of peritoneal dialysis (PD) may slow RKF decline compared to the pre-dialysis period. We sought to evaluate the association between PD initiation and RKF decline in the Initiating Dialysis Early And Late (IDEAL) trial. In this post hoc analysis of the IDEAL randomized controlled trial, PD participants were included if results from 24-hour urine collections had been recorded within 30 days of dialysis initiation, and at least one value pre- and one value post-dialysis commencement were available. The primary outcome was slope of RKF decline, calculated as mean of urinary creatinine and urea clearances. Secondary outcomes included slope of urine volume decline and time from PD initiation to anuria. The study included 151 participants (79 early start, 72 late start). The slope of RKF decline was slower after PD initiation (-2.69±0.18mL/min/1.73m2/yr) compared to before PD (-4.09±0.33mL/min/1.73m2/yr; change in slope +1.19 mL/min/1.73m2/yr, 95%CI 0.48-1.90, p<0.001). In contrast, urine volume decline was faster after PD commencement (-0.74±0.05 L/yr) compared to beforehand (-0...Continue Reading

References

Aug 8, 2002·Kidney International·Maarten A M JansenUNKNOWN NECOSAD Study Group
May 31, 2003·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Fabian TermorshuizenUNKNOWN NECOSAD Study Group
Apr 28, 2009·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Jeffrey Perl, Joanne M Bargman
Jun 29, 2010·The New England Journal of Medicine·Bruce A CooperUNKNOWN IDEAL Study
Mar 24, 2012·Journal of the American Society of Nephrology : JASN·David W JohnsonUNKNOWN balANZ Trial Investigators
Jan 10, 2013·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Dinanda J de JagerUNKNOWN NECOSAD Study Group
Apr 6, 2016·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Lian HeJoanne M Bargman

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Methods Mentioned

BETA
urine collections
urine collection
urine volume collections

Software Mentioned

IDEAL
Stata
CANUSA

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