The anemia in continuous ambulatory peritoneal dialysis patients is related to Kt/V index

Anemia in chronic renal failure causes a number of serious problems to the patient. As a result, it is imperative to make use of all rational options to alleviate it. The present study addresses the question, the answer to wh ich is not yet known, whether or not the degree of anemia depends on the ef ficacy of continuous ambulatory peritoneal dialysis (CAPD) and, if so, what the importance of peritoneal clearance and residual renal function is. A s ignificant correlation between the hematocrit (Hct) and the total weekly Kt /V index (tKt/V) (r = 0.61, p < 0.01), total weekly creatinine clearance (t CLCR) (r = 0.50, p < 0.05), and residual glomerular filtration rate (r = 0. 43, p < 0.05) was demonstrated in a group of 22 CAPD patients. Stepwise reg ression analysis showed that of all the variables monitored, Hct depends ex clusively on tKt/V (p < 0.01, r(2) = 0.37). The value of Hct in a group of patients with a tKt/V < 2.3 (n = 15) was 28.9 +/- 1.2% (arithmetic mean +/- SEM) while in a group with a tKt/V greater than or equal to 2.3 (n = 7), i t was 35.1 +/- 1.9% (p < 0.01). On dividing tKt/V and tCLCR into their peri toneal and renal components, a significant correlation between Hct and rena l Kt/V (r = 0.47, p < 0.05) was found; stepwise regression analysis identif ied renal Kt/V (p < 0.01) and peritoneal Kt/V (p < 0.05), with R-2 = 0.38 a s major variables with an effect on Hct. The authors conclude the efficacy of blood purification is another factor affecting renal anemia in CAPD pati ents. The relationship between anemia and blood purification is best expres sed using the Kt/V index. The Kt/V provided by one's own kidneys seems to b e of greater importance for anemia than the Kt/V provided by peritoneal dia lysis. The results provide the basis for prospective interventional studies .