Effect of Kt/V on survival and clinical outcome in CAPD patients in a randomized prospective study.

@article{citeulike:2941008, abstract = {BACKGROUND: There has been a lack of randomized control study on the effect of Kt/V on patient outcome. This interventional study was designed to examine the effect of Kt/V on continuous ambulatory peritoneal dialysis (CAPD) patients' clinical outcome and nutritional status in a randomized prospective manner. METHOD: A total of 320 new CAPD patients with baseline renal Kt/V <1.0 were recruited from six centers in Hong Kong and were randomized into three Kt/V targets: group A, 1.5 to 1.7; group B, 1.7 to 2.0; and group C,>2.0. Kt/V and nutritional status were assessed every 6 months and dialysis prescription adjusted accordingly. Nutritional assessment included serum albumin and composite nutritional index (CNI). Patients were allowed to withdraw at the discretion of their physicians or themselves. RESULTS: Total Kt/V were significantly different between groups (P = 0.000) and the difference was contributed by peritoneal Kt/V only. The overall 2-year patient survival was 84.9\%. There was no statistical difference in patient survival among the three groups (2-year survival in group A, 87.3\%; group B, 86.1\%; and group C, 81.5\%). However, there were more patients withdrawn by physicians in group A (group A, 16; group B, 7; and group C, 6; P = 0.023). Total Kt/V or Kt did not significantly affect survival after adjustment to age and diabetes. There was no difference in serum albumin, CNI scores, and hospitalization rate, but there were more patients in group A requiring erythropoietin (EPO) treatment after 1 year. CONCLUSION: Patients with total Kt/V maintained below 1.7 had significantly more clinical problems and severe anemia but there was no difference in outcome demonstrated for patients with Kt/V maintained above 2.0 and between 1.7 and 2.0. We recommended that the minimal target of total Kt/V should be above 1.7.}, address = {Division of Nephrology, Department of Medicine, Tung Wah Hospital, and The University of Hong Kong, Hong Kong. wkloc@hkucc.hku.hk}, author = {Lo, W. K. and Ho, Y. W. and Li, C. S. and Wong, K. S. and Chan, T. M. and Yu, A. W. and Ng, F. S. and Cheng, I. K. }, citeulike-article-id = {2941008}, doi = {http://dx.doi.org/10.1046/j.1523-1755.2003.00098.x}, issn = {0085-2538}, journal = {Kidney international}, keywords = {capd, mortality, rct, ukm}, month = {August}, number = {2}, pages = {649--656}, posted-at = {2008-06-29 08:10:16}, priority = {2}, title = {Effect of Kt/V on survival and clinical outcome in CAPD patients in a randomized prospective study.}, url = {http://dx.doi.org/10.1046/j.1523-1755.2003.00098.x}, volume = {64}, year = {2003} }

TY - JOUR ID - citeulike:2941008 L3 - citeulike-article-id:2941008 TI - Effect of Kt/V on survival and clinical outcome in CAPD patients in a randomized prospective study. JF - Kidney international VL - 64 IS - 2 SP - 649 EP - 656 AD - Division of Nephrology, Department of Medicine, Tung Wah Hospital, and The University of Hong Kong, Hong Kong. wkloc@hkucc.hku.hk SN - 0085-2538 N2 - BACKGROUND: There has been a lack of randomized control study on the effect of Kt/V on patient outcome. This interventional study was designed to examine the effect of Kt/V on continuous ambulatory peritoneal dialysis (CAPD) patients' clinical outcome and nutritional status in a randomized prospective manner. METHOD: A total of 320 new CAPD patients with baseline renal Kt/V <1.0 were recruited from six centers in Hong Kong and were randomized into three Kt/V targets: group A, 1.5 to 1.7; group B, 1.7 to 2.0; and group C,>2.0. Kt/V and nutritional status were assessed every 6 months and dialysis prescription adjusted accordingly. Nutritional assessment included serum albumin and composite nutritional index (CNI). Patients were allowed to withdraw at the discretion of their physicians or themselves. RESULTS: Total Kt/V were significantly different between groups (P = 0.000) and the difference was contributed by peritoneal Kt/V only. The overall 2-year patient survival was 84.9%. There was no statistical difference in patient survival among the three groups (2-year survival in group A, 87.3%; group B, 86.1%; and group C, 81.5%). However, there were more patients withdrawn by physicians in group A (group A, 16; group B, 7; and group C, 6; P = 0.023). Total Kt/V or Kt did not significantly affect survival after adjustment to age and diabetes. There was no difference in serum albumin, CNI scores, and hospitalization rate, but there were more patients in group A requiring erythropoietin (EPO) treatment after 1 year. CONCLUSION: Patients with total Kt/V maintained below 1.7 had significantly more clinical problems and severe anemia but there was no difference in outcome demonstrated for patients with Kt/V maintained above 2.0 and between 1.7 and 2.0. We recommended that the minimal target of total Kt/V should be above 1.7. KW - capd KW - mortality KW - rct KW - ukm AU - Lo, WK AU - Ho, YW AU - Li, CS AU - Wong, KS AU - Chan, TM AU - Yu, AW AU - Ng, FS AU - Cheng, IK PY - 2003/08// UR - http://dx.doi.org/10.1046/j.1523-1755.2003.00098.x ER -