Overhydration and low serum prealbumin predict peritoneal dialysis-related peritonitis in continuous ambulatory peritoneal dialysis patients

Quyen Dao Bui Quy,Thang Le Viet,Tien Tran Viet,Tuan Pham Ngoc Huy,Loc Nguyen Duc,Toan Nguyen Duy,Quyet Do,Dung Nguyen Huu,My Pham Van

doi:10.1186/s12882-020-02178-w

Abstract

BackgroundIn this study, we focused on the role of overhydration (OH) and low serum prealbumin concentration in predicting peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients over a 3-year period.MethodsWe measured serum prealbumin concentration and OH by body composition monitor in 278 CAPD patients (159 males and 119 females) with a mean age of 46 years and a median peritoneal dialysis (PD) duration of 21 months. Cases of PD-related peritonitis were collected over 3 years.ResultsAfter the 3-year follow-up, 44 patients were diagnosed with PD-related peritonitis (15.8%). Low education, serum glucose, prealbumin, and OH were independent risk factors for predicting peritonitis over 36 months in CAPD patients. Based on the ROC curve model and Kaplan-Meier analysis, we realized that low prealbumin and high OH were independent predictors of 3-year peritonitis in CAPD patients (Prealbumin: AUC = 0.838, cut-off value = 32.5 mg/dL, Se = 90.9%, Sp = 32.9%; OH: AUC = 0.851, cut-off value = 1.33 L, Se = 79.5%, Sp = 85.5%; and log-rank test p < 0.001, respectively).ConclusionOverhydration and low serum prealbumin were the independent predictors of PD-related peritonitis in CAPD patients.

Highlights

In this study, we focused on the role of overhydration (OH) and low serum prealbumin concentration in predicting peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients over a 3-year period
Peritoneal dialysis (PD) is a renal replacement therapy based on infusing a sterile solution into the peritoneal cavity through a catheter, and it provides for the removal of solutes and water using the peritoneal membrane as the exchange surface [1,2,3]
Factors predicting peritonitis In this study, we found that there were many independent factors related to peritonitis in CAPD patients, of which prealbumin and OH are closely related (p < 0.001) (Table 2)

Summary

Introduction

We focused on the role of overhydration (OH) and low serum prealbumin concentration in predicting peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients over a 3-year period. Similar to other countries around the world, peritonitis often occurs in patients with peritoneal dialysis This causes many patients to switch to maintenance hemodialysis. Chronic fluid overload is related to an increased risk of cardiovascular morbidity and mortality in peritoneal dialysis patients [15]. Prealbumin (transthyretin) is a hepatic secretory protein used to assess malnutrition in PD patients, and it is related to inflammation and atherosclerosis. It has prognostic value for peritonitis and mortality in PD patients [16, 17]. As a result of the above reasons, we conducted this study to determine the prevalence of peritonitis and the predictive values of OH and low serum prealbumin for PD-related peritonitis in Vietnamese peritoneal dialysis patients

Methods

Results

Discussion

Conclusion