Background: There are limited data regarding the relationship between transport status and mortality in anuric continuous ambulatory peritoneal dialysis (CAPD) patients. Methods: According to the dialysate to plasma creatinine ratio (D/P Cr), 292 anuric CAPD patients were stratified to faster (D/P Cr ≥0.65) and slower transport groups (D/P Cr <0.65). The Cox proportional hazards models were used to evaluate the association of transport status with mortality. Results: During a median follow-up of 22.1 months, 24% patients died, 61.4% of them due to cardiovascular disease (CVD). Anuric patients with faster transport were associated with an increased risk of all-cause mortality (HR (95% CI) = 2.16 (1.09-4.26)), but not cardiovascular mortality, after adjustment for confounders. Faster transporters with pre-existing CVD had a greater risk for death compared to those without any history of CVD. Conclusion: Faster transporters were independently associated with high all-cause mortality in anuric CAPD patients. This association was strengthened in patients with pre-existing CVD.

van der Wal WM, Noordzij M, Dekker FW, Boeschoten EW, Krediet RT, Korevaar JC, Geskus RB; Netherlands Cooperative Study on the Adequacy of Dialysis Study Group (NECOSAD): Full loss of residual renal function causes higher mortality in dialysis patients; findings from a marginal structural model. Nephrol Dial Transplant 2011;26:2978-2983.
Li PK, Chow KM: Maximizing the success of peritoneal dialysis in high transporters. Perit Dial Int 2007;27(suppl 2):S148-S152.
Davies SJ, Brown EA, Frandsen NE, Rodrigues AS, Rodriguez-Carmona A, Vychytil A, Macnamara E, Ekstrand A, Tranaeus A, Filho JC; EAPOS Group: Longitudinal membrane function in functionally anuric patients treated with APD: data from EAPOS on the effects of glucose and icodextrin prescription. Kidney Int 2005;67:1609-1615.
Brown EA, Davies SJ, Rutherford P, Meeus F, Borras M, Riegel W, Divino Filho JC, Vonesh E, van Bree M; EAPOS Group: Survival of functionally anuric patients on automated peritoneal dialysis: the European APD outcome study. J Am Soc Nephrol 2003;14:2948-2957.
Churchill DN, Thorpe KE, Nolph KD, Keshaviah PR, Oreopoulos DG, Pagé D: Increased peritoneal membrane transport is associated with decreased patient and technique survival for continuous peritoneal dialysis patients. The Canada-USA (CANUSA) peritoneal dialysis study group. J Am Soc Nephrol 1998;9:1285-1292.
Rumpsfeld M, McDonald SP, Johnson DW: Higher peritoneal transport status is associated with higher mortality and technique failure in the Australian and New Zealand peritoneal dialysis patient populations. J Am Soc Nephrol 2006;17:271-278.
Cueto-Manzano AM, Correa-Rotter R: Is high peritoneal transport rate an independent risk factor for CAPD mortality? Kidney Int 2000;57:314-320.
Park HC, Kang SW, Choi KH, Ha SK, Han DS, Lee HY: Clinical outcome in continuous ambulatory peritoneal dialysis patients is not influenced by high peritoneal transport status. Perit Dial Int 2001;21(suppl 3):S80-S85.
Chung SH, Heimbürger O, Stenvinkel P, Wang T, Lindholm B: Influence of peritoneal transport rate, inflammation, and fluid removal on nutritional status and clinical outcome in prevalent peritoneal dialysis patients. Perit Dial Int 2003;23:174-183.
Yang X, Fang W, Bargman JM, Oreopoulos DG: High peritoneal permeability is not associated with higher mortality or technique failure in patients on automated peritoneal dialysis. Perit Dial Int 2008;28:82-92.
Dong J, Xu Y, Li Y, Yang Z: Does association with volume status and inflammation account for the increased death risk from high peritoneal protein clearance in peritoneal dialysis? Blood Purif 2010;30:127-134.
Lin X, Lin A, Ni Z, Yao Q, Zhang W, Yan Y, Fang W, Gu A, Axelsson J, Qian J: Daily peritoneal ultrafiltration predicts patient and technique survival in anuric peritoneal dialysis patients. Nephrol Dial Transplant 2010;25:2322-2327.
Lo WK, Lui SL, Chan TM, Li FK, Lam MF, Tse KC, Tang SC, Choy CB, Lai KN: Minimal and optimal peritoneal Kt/V targets: results of an anuric peritoneal dialysis patient's survival analysis. Kidney Int 2005;67:2032-2038.
Twardowski ZJ, Nolph KD, Khanna R, et al: Peritoneal equilibration test. Perit Dial Bull 1987;7:138-147.
Xu Q, Xiong L, Fan L, Xu F, Yang Y, Li H, Peng X, Cao S, Zheng Z, Yang X, Yu XQ, Mao H: Association of pulmonary hypertension with mortality in incident peritoneal dialysis patients. Perit Dial Int 2014, Epub ahead of print.
Wang T, Heimbürger O, Waniewski J, Bergström J, Lindholm B: Increased peritoneal permeability is associated with decreased fluid and small-solute removal and higher mortality in CAPD patients. Nephrol Dial Transplant 1998;13:1242-1249.
Chung SH, Heimbürger O, Lindholm B, Lee HB: Peritoneal dialysis patient survival: a comparison between a Swedish and a Korean centre. Nephrol Dial Transplant 2005;20:1207-1213.
Paniagua R, Amato D, Vonesh E, Correa-Rotter R, Ramos A, Moran J, Mujais S; Mexican Nephrology Collaborative Study Group: Effects of increased peritoneal clearances on mortality rates in peritoneal dialysis: ADEMEX, a prospective, randomized, controlled trial. J Am Soc Nephrol 2002;13:1307-1320.
Rodrigues AS, Almeida M, Fonseca I, Martins M, Carvalho MJ, Silva F, Correia C, Santos MJ, Cabrita A: Peritoneal fast transport in incident peritoneal dialysis patients is not consistently associated with systemic inflammation. Nephrol Dial Transplant 2006;21:763-769.
Guo Q, Yi C, Li J, Wu X, Yang X, Yu X: Prevalence and risk factors of fluid overload in Southern Chinese continuous ambulatory peritoneal dialysis patients. PLoS One 2013;8:e53294.
Gangji AS, Brimble KS, Margetts PJ: Association between markers of inflammation, fibrosis and hypervolemia in peritoneal dialysis patients. Blood Purif 2009;28:354-358.
John B, Tan BK, Dainty S, Spanel P, Smith D, Davies SJ: Plasma volume, albumin, and fluid status in peritoneal dialysis patients. Clin J Am Soc Nephrol 2010;5:1463-1470.
Reyes MJ, Bajo MA, Hevía C, Del Peso G, Ros S, de Miguel AG, Cirugeda A, Castro MJ, Sánchez-Tomero JA, Selgas R: Inherent high peritoneal transport and ultrafiltration deficiency: their mid-term clinical relevance. Nephrol Dial Transplant 2007;22:218-223.
Chung SH, Chu WS, Lee HA, Kim YH, Lee IS, Lindholm B, Lee HB: Peritoneal transport characteristics, comorbid diseases and survival in CAPD patients. Perit Dial Int 2000;20:541-547.
Kang DH, Yoon KI, Choi KB, Lee R, Lee HY, Han DS, Cho EY, Lee JH: Relationship of peritoneal membrane transport characteristics to the nutritional status in CAPD patients. Nephrol Dial Transplant 1999;14:1715-1722.
Zhang F, Liu H, Gong X, Liu F, Peng Y, Cheng M, Zhang H, Liu Y, Liu Y, Guo C: Risk factors for mortality in Chinese patients on continuous ambulatory peritoneal dialysis. Perit Dial Int 2015;35:199-205.
Kircelli F, Asci G, Yilmaz M, Sevinc Ok E, Demirci MS, Toz H, Akcicek F, Ok E, Ozkahya M: The impact of strict volume control strategy on patient survival and technique failure in peritoneal dialysis patients. Blood Purif 2011;32:30-37.
Foley RN, Parfrey PS, Sarnak MJ: Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 1998;32(5 suppl 3):S112-S119.
Collins AJ, Hao W, Xia H, Ebben JP, Everson SE, Constantini EG, Ma JZ: Mortality risks of peritoneal dialysis and hemodialysis. Am J Kidney Dis 1999;34:1065-1074.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.