ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Abstract: SA-PO640

Evaluation of Impact of Residual Renal Function on Clinical Outcome, Quality of Life, and Prognosis in Patients on Continuous Ambulatory Peritoneal Dialysis (CAPD)

Session Information

  • Home Dialysis - II
    November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Kakoti, Sweety, Apollo Hospitals Guwahati, Guwahati, Assam, India
  • Bora, Mitul, Apollo Hospitals Guwahati, Guwahati, Assam, India
  • Das, Tonmoy, Apollo Hospitals Guwahati, Guwahati, Assam, India
  • Choudhury, Dhruvajyoti, Apollo Hospitals Guwahati, Guwahati, Assam, India
Background

Residual renal function (RRF) in patients with ESRD receiving dialysis is defined as the ability of the native kidneys to eliminate water and uremic toxins. It provides small solute clearance, has role in maintaining fluid balance, phosphorus control, and removal of middle molecular uremic toxins, and contributes significantly to the overall health. It is a powerful predictor of mortality.

Methods

A Prospective Observational Study conducted in Apollo Hospitals, Guwahati for 1year. Study Population included all patients who were initiated on CAPD during this study period after excluding those fulfilling exclusion criteria. Their RRF was calculated as the average of urea clearance (Kru) and creatinine clearance (Crcl) in 24 hrs urine sample.
All patients were followed up at regular intervals - at the time of initiation of CAPD, 3 and 6 months with clinical, laboratory parameters, prognostic markers.

Results

Following observations were made during the study:
Total number of cases was 50 with mean age of 61.6 years with majority (54%) in elderly age group (>60 years) with a male to female ratio of 2.57:1.
Most common co-morbidities were hypertension (92%), diabetes (60%), CAD (26%), hypothyroidism (24%).
Native kidney diseases observed were diabetic nephropathy (52%), hypertensive nephropathy (50%), chronic glomerulonephritis (14%), chronic tubulointerstitial diseases (4%).
Mean renal reserve deteriorated over time from 4.27 ml/min/1.73m2 at baseline to 4.11 ml/min/1.73m2 at 3 months and 3.91 ml/min/1.73m2 at 6 months (p<0.01).
36% cases showed a fall of renal reserve >0.5 ml/ min/ 1.73 m2 and 36% showed low renal reserve (0.5 ml/ min/1.73 m2). These cases were observed to be significantly associated with lower urine output, hemoglobin, platelet, sodium, albumin, bicarbonate, vitamin D levels and higher creatinine, potassium, PTH, phosphorus levels, higher degree of malnutrition, depression, co-morbidities, poorer quality of life parameters (p<0.01), more incidence of respiratory infections, peritonitis and also higher mortality.

Conclusion

Our study showed low RRF deteriorates over time. A significant correlation between low RRF at baseline and malnutrition, depression symptoms, poor quality of life and solute clearance. Hence preservation of RRF is an essential marker of patient prognosis in CAPD.