- 期刊
初始殘餘腎功能與殘餘腎功能喪失速率對 CAPD 病人預後的影響
Impact of ＂Initial Baseline＂ and ＂Fast Decline＂ in Residual Renal Function on Long-Term Outcomes in CAPD Patients
並列摘要
Residual renal function (RRF) has been found to play a pivotal role in the long-term survival of continuous ambulatory peritoneal dialysis (CAPD) patients. Preservation of RRF is crucial to maintain dialysis adequacy. However, high baseline renal function was paradoxically reported as a risk factor for rapid decline of RRF. The exact association remains to be determined. In this report, we discuss whether fast decline in RRF or initial anuria has a greater impact on long-term outcomes of CAPD patients, and also to show how the clinical characteristics differ. We found that ＂slow RRF decline rate＂ and ＂high initial RRF status＂ offer an equal survival benefit to PD patients without co-morbidities. However, in those with higher comorbid conditions, rapidity of RRF decline is a more important determinant over baseline RRF. Owing to the co-morbid conditions and subsequent inter-current kidney injuries, and despite having the advantage of highest baseline urine volume, the fast RRF decliners lost renal function within a short period. Thus, both ＂initial anuria＂ and ＂rapid RRF decline＂ share a common pathway of ＂early＂ RRF loss, which leads to a high mortality risk. Therefore, strategies to preserve renal function should be made. Careful management of the co-morbid conditions is important.