Estimated Glomerular Filtration Rate —A More Stable Indicator than Creatinine
Clearance in Peritoneal Dialysis Practice |
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Authors: | Yoshitaka Maeda Sayaka Yoshida Toshiyuki Hirai Tomoki Kawasaki Tamaki Kuyama |
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Institution: | Nephrology Division, Department of Internal Medicine, JA Toride Medical Center, Japan |
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Abstract: | Objective: The usefulness of estimated glomerular filtration rate may not be
restricted to pre-dialysis patients, since we reported that estimated glomerular
filtration rate was well correlated with measured total creatinine clearance in peritoneal
dialysis patients. To clarify the clinical usefulness of estimated glomerular filtration
rate as a parameter for peritoneal dialysis adequacy, we retrospectively surveyed
estimated glomerular filtration rate and total creatinine clearance in peritoneal dialysis
patients treated at JA Toride Medical Center.Patients and Methods: A total of 114 data sets of estimated glomerular
filtration rate and total creatinine clearance from 21 PD patients treated at JA Toride
Medical Center were collected from November 2010 to October 2011. The patients consisted
of 15 men and six women with an average age of 66.6 ± 12.6 years (46–95 years old). The
average number of samples was 5.4 ± 1.5 (2 to 7) per patient.Results: The collected data showed less correlation of estimated glomerular
filtration rate and total creatinine clearance (r. = 0.435) than that of a previous
cross-sectional study (r. = 0.836). As reported in pre-dialysis patients, the differences
between estimated glomerular filtration rate and total creatinine clearance were
correlated with total creatinine excretion in urine and PD effluent (r. = 0.821). The
differences were also correlated with normalized protein catabolic rate, which was one of
the main determinant factors for total creatinine excretion (r. = 0.636). A similar
tendency was apparently observed in one patient with poor compliance to diet therapy and
fluctuating dietary intake. From the analysis of these data, serum creatinine seemed to
fluctuate less possibly due to compensatory capacity of the residual renal function in
small solute clearance.Conclusions: Consequently, estimated glomerular filtration rate was turned
out to be a more stable parameter than total creatinine clearance, which might be a
desirable feature in long-term follow-up of peritoneal dialysis patients. |
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Keywords: | eGFR Ccr PD creatinine creatine |
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