In:
PLOS ONE, Public Library of Science (PLoS), Vol. 15, No. 11 ( 2020-11-16), p. e0242254-
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. Methods 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. Results 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/1.73m 2 /yr) compared to before PD (-4.09±0.33mL/min/1.73m 2 /yr; change in slope +1.19 mL/min/1.73m 2 /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 (-0.57±0.06L/yr; change in slope -0.18L/yr, 95%CI -0.34—-0.01, p = 0.04). No differences were observed between the early- and late-start groups with respect to RKF decline, urine volume decline or time to anuria. Conclusions Initiation of PD was associated with a slower decline of RKF compared to the pre-dialysis period.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0242254
DOI:
10.1371/journal.pone.0242254.g001
DOI:
10.1371/journal.pone.0242254.g002
DOI:
10.1371/journal.pone.0242254.t001
DOI:
10.1371/journal.pone.0242254.t002
DOI:
10.1371/journal.pone.0242254.t003
DOI:
10.1371/journal.pone.0242254.t004
DOI:
10.1371/journal.pone.0242254.s001
DOI:
10.1371/journal.pone.0242254.s002
DOI:
10.1371/journal.pone.0242254.s003
DOI:
10.1371/journal.pone.0242254.s004
DOI:
10.1371/journal.pone.0242254.s005
DOI:
10.1371/journal.pone.0242254.s006
DOI:
10.1371/journal.pone.0242254.s007
DOI:
10.1371/journal.pone.0242254.s008
DOI:
10.1371/journal.pone.0242254.s009
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2020
detail.hit.zdb_id:
2267670-3
Permalink