Kidney Week

Abstract: SA-PO468

Decline of Kidney Function before and after Start of Peritoneal Dialysis (PD)

Session Information

• Home Dialysis - 2
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

• Björksten, Markus, Karolinska Institutet Institutionen for Klinisk Vetenskap Intervention och Teknik, Huddinge, Sweden

Markus Björksten, MD

• Qureshi, Abdul Rashid Tony, Karolinska Institutet Institutionen for Klinisk Vetenskap Intervention och Teknik, Huddinge, Sweden

Abdul Rashid Tony Qureshi, MD, PhD

• Stenvinkel, Peter, Karolinska Institutet Institutionen for Klinisk Vetenskap Intervention och Teknik, Huddinge, Sweden

Peter Stenvinkel, MD, PhD, FASN

• Heimburger, Olof, Karolinska Institutet Institutionen for Klinisk Vetenskap Intervention och Teknik, Huddinge, Sweden

Olof Heimburger, MD, PhD

Background

Residual kidney function (RKF) is a key component for PD adequacy and is associated with improved volume status, and clinical outcome. The RKF decline rate has been reported to diminish after PD initiation. The aim was to compare kidney function decline, and diuresis decline, before and after start of PD, and to compare eGFR and GFR from urine collections (uGFR) predialysis.

Methods

We studied 138 patients (42% females, mean age 55±13 years) starting PD during 2000-2019 in a prospective study. Inclusion criteria were > 1 urine collection before, and > 1 after PD initiation, PD initiation < 6 months after study inclusion and > 6 months of PD. Data was collected from 12 months before to 12 months after PD start. uGFR was calculated as average of creatinine and urea clearance from 24-hour urine collections corrected for BSA. eGFR was calculated using CKD-epi 2021.

Results

The mean uGFR was 15.5±6.2 and eGFR 12.1±5.8 at 12 months before PD start, and PD was started at mean uGFR 8.5±2.3 and eGFR 5.8±1.9 ml/min/1.73m². The GFR decline rate before PD start was similar using eGFR or uGFR. However, uGFR was higher than eGFR. The uGFR decline rate was slower after PD start. Notably, there was a marked attenuation at 1 month of PD. However, urine volume decline rate increased after PD start, likely because of peritoneal ultrafiltration.

Conclusion

The results could suggest that an earlier initiation of PD may be beneficial for preservation of RKF.

Funding

• Private Foundation Support