The status on achieving Kt/Vurea target and its relation with residual renal function and clinical characteristics of peritoneal dialysis patients

ObjectiveTo explore the present status on achieving Kt/Vurea target in Chinese peritoneal dialysis (PD) patients and its relation with residual renal function (RRF) and clinical characteristics. Methods This was a cross-sectional study carried out in 5 PD centers in different area of China. Totally 681 clinical stable PD patients with duration≥3 months who completed dialysis adequacy and biochemical test during April 1st, 2011 and August 31st, 2011 were enrolled in this study. The demographic data and clinical characteristics were compared according to varied Kt/Vurea and RRF levels. Results (1)The total Kt/Vurea was 1.95±0.59，and total Ccr was （63.80±30.84）L·week-1·(1.73 m2) -1 for the whole group, there were 67.4% subjects achieving the Kt/Vurea target. (2) Patients achieving Kt/Vurea targetwere prone to be female and had smaller size with higher RRF and urine volume (P＜0.05). The serum calcium and phosphorus were controlled well in these patients (P＜0.05). They also had better higher cholesterol and low-density lipoprotein, and lower CRP level and less complications (P＜0.05). (3)Serum albumin was higher but inflammation and complications were less in patients with Kt/Vurea value≥1.7 and RRF≥2 ml·min-1·（1.73 m2）-1 (subgroup 1), as compared to those with Kt/Vurea≥1.7 but RRF＜2 ml·min-1·（1.73 m2）-1 (subgroup 2) and those with Kt/Vurea＜1.7(subgroup 3) (P＜0.05). The subgroup 2 and 3 were statistically different in these clinical indices, serum calcium [(2.22±0.21) mmol/L vs (2.14±0.24) mmol/L, P＜0.01], serum phosphorous [(1.43±0.47) mmol/L vs (1.66±0.52) mmol/L, P＜0.01], cholesterol [(4.91±1.29) mmol/L vs (4.62±0.99) mmol/L, P＜0.05], low-density lipoprotein [(2.86±0.96) mmol/L vs (1.13±0.61) mmol/L, P＜0.01], high-density lipoprotein [(1.08±0.33) mmol/L vs (2.20±0.72) mmol/L, P＜0.01]. (4)The Kt/Vurea was positively correlated with RRF (R2＝0.317); if RRF decreased 1 ml/min, the hazard of Kt/Vurea un-targeting increased 40.3%. Conclusions About 67.4% of PD patients can reach the Kt/Vurea target recommended by K/DOQI. RRF makes a great contribution to Kt/Vurea target. The clinical characteristics are poorer in patients who can not achieve the Kt/Vurea target, or with worse RRF.