You are here

SPOT DİYALİZAT ÖRNEĞİNDE BAKILAN PROTEİN/KREATİNİN ORANI GÜNLÜK DİYALİZAT PROTEİN KAYBINI TAHMİNDE KULANILABİLİR Mİ?

CAN DAILY DIALYSATE PROTEIN LOSS BE PREDICTED FROM PROTEIN/ CREATININE RATIO ?

Journal Name:

Publication Year:

Abstract (2. Language): 
Peritoneal dialysis (PD) is a commonly used renal replacement method. These patients lose 5-10 gram/ day protein during the dialysis procedure. The losses are greater in high transporters, during the peritonitis attack and in case of peritoneal fibrosis. Urine Protein / Creatinine ratio is a practical method and used to estimate daily protein loss in clinical nephrology. The aim of the present study was to investigate the relationship between dialysate proteine/creatinine ratio and daily protein loss. We studied 12 stable PD patients [6 men, 6 women; mean age: 31 ± 8 years. Patients underwent a standard peritoneal equilibration test (PET). In addition, dialysate protein was measured in fourth hour samples and 24 hours dialysate samples. Daily protein loss calculated from protein/creatinine ratio and from protein in the 24 hours samples* daily dialysate volume. The mean of protein loss in the dialysate was 9.3±2.8 g/day and 11.5+3.5 g/day in the 24 hours sample and protein/creatinine ratio, respectively. There is a significant correlation between two methods (r=0.71, p< 0.05). In conclusion, according to our results, Protein/ Creatinine ratio is a useful method to estimate daily protein loss in the patients underwent routine PET
Abstract (Original Language): 
Periton diyalizi (PD), günümüzde sıkça kullanılan bir renal replasman tedavisidir. Diyalizat ile ortalama olarak 5-10 gr/gün kadar protein kaybedilmektedir. Yüksek geçirgen olanlarda, peritonit sırasında ve peritoneal fibrozis durumlarında diyalizat protein kaybı artmaktadır. Diyalizattaki protein kaybı ile düşük serum albumin ve peritoneal transport arasında ilişki olduğu bilinmektedir. Spot idrarda protein/kreatinin oranı, günlük protein kaybım saptamak için nefrolojide sıkça kullanılan pratik bir yöntemdir. Bu çalışmada, benzer bir yaklaşımla, PET diyalizat örneğinde P/Kr oranı ile günlük diyalizat protein kaybı arasındaki ilişkiyi araştırmayı amaçladık. PD poliklinik takibinde olan stabil 12 hasta (ortalama yaş 31 ±8 yıl; 6 K, 6E) çalışmaya alındı. 24 saatlik diyalizat ve PET3 (4 saat) diyalizat örnekleri alındı. Turbimetrik yöntemle örneklerde protein çalışıldı. Günlük protein kaybı: protein x günlük diyalizat volumü ve PET3 diyalizat örneğinde P/Kr oranı kullanılarak hesaplandı ve korelasyon analizi uygulandı. Ortalama günlük diyalizat protein kaybı; 24 saatlik örneğe göre 9.3±2.8 g/gün bulunurken; Pr/ Kr' ne göre ise 11.5+3.5 gr/gün bulundu. İki yöntem arasında yapılan korelasyon analizinde r =0.71 bulundu (p< 0.05). Tarafımızca yapılan bu ön çalışmada; PET örneğinden bakılan Pr/kret oranının günlük protein kaybını %71 oranında yansıttığı saptanmıştır. Kanımızca PET3 prot/kreat oranı günlük diyalizat protein kaybını tahmin etmede kullanılabilecek, PET sırasında ek bir işlem gerektirmeden yapılabilecek, kolay bir yöntem olabilir.
FULL TEXT (PDF): 
206-208

REFERENCES

References: 

1. Nolph KDA, Moore HL, Pro want B et al. Continuous ambulatory peritoneal dialysis with a high flux membrane. ASAIO J 1993; 39: 904-909.
2. Fried LF. Higher membrane permeability predicts poorer patient survival. Perit Dial Int 1997; 17: 387-389.
3. Churchill DN, Thorpe KE, Nolph KD et al, for the CANUSA Peritoneal Dialysis Study Group. Increased peritoneal membrane transport is associated with decreased patient and technique survival for continuous peritoneal dialysis patients. J Am Soc Nephrol 1998; 9: 1285-1292.
4. Davies SJ, Bryan J, Phillips L et al. Longitudinal changes in peritoneal kinetics. The effects of peritoneal dialysis and peritonitis. Nephrol Dial Transplant 1996; 11: 498-506.
5. Blake PG, Flowerdew G, Blake RM et al. Serum
albumin in patients on continuous peritoneal dialysis—predictors and correlations with
outcomes. J Am Soc Nephrol 1993; 3: 1501-1507.
6. Wang T, HeimbUrger O, Waniewski J et al. Increased peritoneal permeability is associated with decreased fluid and small-solute removal and higher mortality in CAPD patients. Nephrol Dial
Transplant 1999; 13: 1242-1249.
7. Kang PH, Yoon KI, Choi KB et al. Relationship of
peritoneal membrane transport characteristics to the nutritional status in CAPD patients. Nephrol
Dial Transplant 1999; 14: 1715-1722.
8. Cueto-Manzano AM, Correa-Rotter R. Is high peritoneal transport rate an independent risk factor for CAPD mortality? Kidney Int 2000; 57: 314¬320.
9. Margetts PJ, McMullin JP, Rabbat CG et al.
Peritoneal membrane transport and hypoalbuminemia: cause or effect? Perit Dial Int
2000; 20: 14-18.
10. Davies SJ, Brown B, Bryan J et al. Clinical evaluation of the peritoneal equilibration test. A population based study. Nephrol Dial Transplant
1993;8:64-70.
11. Ginsberg JM; Chang BS; Matarese RA; Garella S
Use of single voided urine samples to estimate quantitative proteinuria. - N Engl J Med 1983 Dec
22;309(25): 1543-6.
12. Schwab SJ, Christensen RL, Dougherty K et al. Quantitation of proteinuria by the use of protein-to-creatinine ratios in single urine samples. Arch
Intern Med 1987 May;147(5): 943-944.
13. Abitbol C, Zilleruelo G, Freundlich M et al.
Quantitation of proteinuria with urinary protein/ creatinine ratios and random testing with dipsticks in nephrotic children. J Pediatr 1990 Feb; 116(2): 243-247.
14. Steinhauslin F; Wauters JP. Quantitation of proteinuria in kidney transplant patients: accuracy of the urinary protein/creatinine ratio. Clin
Nephrol 1995 Feb;43(2): 110-115.
15. Chitalia VC; Kothari J; Wells EJ; Livesey JH;
Robson RA; Searle M; Lynn KL Cost-benefit analysis and prediction of 24-hour proteinuria from the spot urine protein-creatinine ratio. - Clin
Nephrol 2001 Jun;55(6): 436-447.
16. Cooper S, Iliescu EA, Morton AR, The relationship between dialysate protein loss and membrane transport status in peritoneal dialysis
patients. Adv Perit Dial. 2001 ;17: 244-247.
17. Blake PG. What is the problem with high
transporters? Perit Dial Int 1997; 17: 317-320.
18. Harty JC, Boulton H, Venning MC, Gokal R. Is
peritoneal permeability an adverse risk factor for malnutrition in CAPD patients? Miner Electrolyte
Metab 1996;22:97-101.

Thank you for copying data from http://www.arastirmax.com