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Abstract: PO1313

Blood Urea Nitrogen/Creatinine Ratio and Mortality in Patients on Continuous Ambulatory Peritoneal Dialysis

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Wu, Xianfeng, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
  • Wu, Junnan, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
  • Wang, Niansong, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
Background

Little is known about the association between the Nitrogen/Creatinine( BUN/Cr) ratio and mortality in continuous ambulatory peritoneal dialysis (CAPD) patients.

Methods

We conducted a retrospective study of eligible 2837 patients on CAPD from five dialysis centers in Chinese between January 1, 2005 and December 31, 2018. We calculated baseline BUN/Cr ratio, and then estimated the hazard ratio (HR) of BUN/Cr ratio for all-cause mortality using Cox hazard regression models, and used the restricted cubic spline curve to evaluate the association between the BUN/Cr ratio and mortality, with adjusting for confoundering factors.

Results

The median age of at baseline was 50.0 years (39.0-61.0) and the baseline median BUN/Cr ratio was 7.02 (5.43-9.13). The median observational period was 35.3 (18.3-61.9) months. During this period, 509 (17.9%, 95% CI 16.5 to 19.4%) of 2837 patients died, with 253 (8.9%, 95% CI 7.9% to 9.9%) CVD mortality. The incidence of all-cause mortality was 39.8, 48.9, 50.2 and 70.7/patient-years, and CVD mortality incidence was 19.0, 26.0, 28.1, 30.9/1000 patient-years among quartile 1, quartile 2, quartile 3, and quartile 4, respectively. When using BUN/Cr ratio of ≤5.43 as a reference, those with BUN/Cr ratio ≥9.14 had 1.72 (95% confidence interval, 1.34 to 2.22) of HR for all-cause mortality and 1.66 (95% confidence interval, 1.15 to 2.40) of HR for CVD mortality, after adjusting for baseline characteristics and laboratory variables. Cubic spline showed there was a linear association between the baseline BUN/Cr ratio and the risk of all-cause and CVD mortality, with a higher risk of mortality at a higher BUN/Cr ratio (Figure 1).

Conclusion

In conclusion, the BUN/Cr ration at the start of dialysis therapy was independently associated with all-cause and CVD mortality among CAPD patients, with a higher risk of mortality at a higher BUN/Cr ratio.