Abstract: SA-PO1007
Comparing the Prognostic Value of eGFR and Residual Urine Volume in New Dialysis Patients
Session Information
- Hemodialysis and Frequent Dialysis - V
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Yang, Chiehlun, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Ma, Xinxin, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Chen, Yan-ru, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Gangyi, Chen, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
- Peng, Yu, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- Peng, Hui, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
Background
Residual renal function (RRF) is a pivotal predictor for long-time outcome of maintenance dialysis patients that can be assessed by simply measuring residual urine volume (RUV) or calculating estimated glomerular filtration rate (eGFR) at the start of dialysis. However, it remains unknown which one is better for prognostic evaluation as the substitution of RRF in new dialysis patients.
Methods
This is a multiple-center, retroperspective cohort study. Patients who started dialysis between January1, 2008 and December 31, 2017 at the third affiliated hospital of Sun-Yat Sen University were eligible for the study with follow-up through June 30, 2018. The data was collected at the start of dialysis. All eGFR was calculated by eGFR-EPI equation. Main endpoint was all-cause mortality. The predictive accuracy and discriminative ability of the nomogram were determined by a concordance index (C-index) and calibration curve and were compared with eGFR-EPI and RUV. The results were validated with data from dialysis patients at the other two institution enrolled from 2008 to 2017.
Results
612 patients were included in the primary cohort, while 236 patients were enrolled in the validation cohort. Compared with eGFR, RUV showed a better prognostic value for dialysis patients both in the primary and validation cohort either by K-M method or cox regression analysis. Independent risk factors derived from multivariable analysis of the primary cohort to predict mortality were age, diabetes mellitus, mean blood pressure, albumin, uric acid which were all assembled into the nomogram with RUV (nomogram B) or with eGFR (nomogram A). The calibration curve for the probability of mortality showed that the nomogram B (RUV) predictions were in better agreement with actual observations. The C-index of nomogram B (RUV) for predicting mortality was 0.680 (P =0.004), which was statistically higher than the C-index values of nomogram A (0.570). The results were confirmed in the validation cohort.
Conclusion
Our results show that higher residual urine volume at the beginning of dialysis was associated with lower risk of mortality, that indicates the RUV has a better prognostic value than eGFR at the beginning of dialysis for maintenance dialysis patients.