Kidney Week

Abstract: FR-PO668

Risk Factors for Loss of Residual Renal Function During the First Year of Chronic Automated Peritoneal Dialysis (APD) in Children

Session Information

• Dialysis: Peritoneal Dialysis - II
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 703 Dialysis: Peritoneal Dialysis

Author

• Shen, Qian, Children''s Hospital of Fudan univeristiy, Shanghai, China

Qian Shen,

Background

In chronic dialyzed patients, preservation of residual renal function is associated with better survival, lower morbidity, and greater quality of life. The aim of this study was to assess risk factors for loss of residual renal function (RRF) in children during the first year of chronic automated peritoneal dialysis (APD).

Methods

The study group included 56 children (33 boys and 23 girls, median age 9.58 years) with end-stage renal disease (ESRD) at Children’s Hospital of Fudan University from Jan 2008 to Dec 2015 who commenced APD as the initial method of renal replacement therapy for at least 12 months with significant initial residual renal function (daily diuresis more than 100ml/m²/day). Patient characteristics and potential risk factors of developing oligoanuria (under 100 ml/m²/day) including gender, BMI and age at APD, etiology of ESRD, baseline daily diuresis and residual glomerular filtration rate (rGFR), PD fluid volume, glucose load, ultrafiltration, peritoneal permeability, dialysis adequacy, blood pressure, biochemical parameters, medications used and dialysis-related peritonitis frequency were analyzed.

Results

1. Mean diuresis before initiation of APD was 692.0±315.9 (mL/m²/day) and mean rGFR was 7.48±2.93 (mL/min/1.73 m²). An average decline of daily urine volume was 376.2±354.6 (mL/m²/day) in the first year of APD and 23 (41.14%) children became oligoanuria.
2. Risk factors associated with loss of RRF: Children who lost RRF during the first year frequently exhibited a lower baseline rGFR (P=0.02), were exposed to higher dialysate glucose (P<0.001), higher PD fluid volume (P=0.002) and achieved higher daily ultrafiltration volume (P<0.001). The use of RAS antagonists (ACEI/ARB) tended to increase the risk of becoming oligoanuria (P=0.003).

Conclusion

The important risk factors for rapid RRF loss in children during the first year of chronic APD include lower baseline rGFR, higher glucose load, higher PD fluid volume, higher ultrafiltration and administration of RAS antagonists.