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Abstract: SA-PO962

Uric Acid Clearance in Peritoneal Dialysis Patients

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Xiao, Xi, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
  • Peng, Yuan, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
  • Huang, Xuan, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
  • Wu, Meiju, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
  • Yu, Xueqing, Department of Nephrology, Guangdong Provincial People's Hospital, Guangzhou, China
  • Yang, Xiao, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
Background

There's a paucity of systematic study focus on the clearance of UA in peritoneal dialysis (PD) . The aim of this study was to investigate the peritoneal UA transport and its influence factors in PD patients.

Methods

This was a cross-sectional study. The patients who performed peritoneal equilibration test (PET) and Kt/V from April 1, 2018 to April 31, 2019 were enrolled. The demographic data, clinical and laboratory parameters including the UA levels in the dialysate, blood and urine samples were collected.

Results

Totally 122 prevalent PD patients(male 55.7%) were enrolled in this study, with a mean age of 46.2±13.1 years and a mean peritoneal UA clearance (pUACL) of 40.1±6.9 L/week/1.73 m2.The average mass transfer of UA between 0-4h dwell with 2L of 2.5% dextrose solution was 22.2±5.2 mg/h. Compared with the normal serum UA group, the hyperuricemia group showed significantly lower pUACL (38.0±5.7 vs.41.8±7.3L/week/1.73m2, p=0.003). The bivariable correlation analysis revealed that the serum UA levels was positively correlated with the UA mass transfer (r=0.715, p<0.001) but negatively correlated with pUACL (r=-0.310, p=0.001). Furthermore, the higher (high or high-average) transporters showed greater pUACL than the lower (low or low-average) transporters (42.0±7.1vs.36.7±4.9L/week/1.73 m2, p<0.001). The 4 hours dialysate to plasm (4h D/P) ratios of UA correlated fairly well with the ratios of creatinine (r=0.933, p<0.001). And the correlation between the pUACL and 4h D/P UA (r=0.446, p<0.001) or creatinine (r=0.428, p<0.001) were similar. Among the widely used solute removal evaluation indicators, the peritoneal creatinine clearance performed best to predict higher pUACL in the ROC analysis (area under curve AUC 0.951,95%CI0.908-0.993). On multivariable logistic regression, each 1kg/m2 decrease of BMI [odd ratios (OR) 0.761, 95% CI0.634-0.913], each 1mL increase of the dialysis dose (OR1.001,95%CI1.000-1.002), each 0.1% increase of the average glucose concentration of dialysate (OR1.400,95%CI1.017-1.927), female sex (OR5.170,95%CI1.819-14.695) and higher transporters (OR5.749,95%CI 1.795-18.406) were independently associated with higher pUACL.

Conclusion

The clearance of UA in PD were similar to that of creatinine. Increasing dialysis dose or glucose concentration of the solution may help to control the hyperuricemia in lower transporters.

Funding

  • Government Support - Non-U.S.