IS RESIDUAL URINE OUTPUT ASSOCIATED WITH THE BETTER PERITONEAL DIALYSIS OUTCOMES IN A SINGLE CENTRE?

RACHEL BRENNAN¹, KAI-XING GOH², HILTON GOCK²

¹Wide Bay Hospital Health Service, , Australia , ²St Vincent’s Hospital, Melbourne , Australia

Background: Urine volume (UV) has been shown to be positively correlated with improved outcomes and a reduction in the relative risk of death in patients on peritoneal dialysis (PD). For the 2013–2018 period, St Vincent’s Hospital Melbourne (SVHM) had superior patient and PD technique survival compared to the national average on the ANZDATA Centre Report.

Aim: To provide insight into the SVHM PD patient cohort, with a focus on residual urine output as a potential explanation for the difference in outcome.

Methods: A retrospective analysis was conducted on PD patients at SVHM who commenced PD between January 2013 and September 2020. Patient characteristics and the UV recorded on PD adequacy tests at <12, 12-24 and >24 months after commencing PD were analysed. Peritonitis rates were also examined.

Results: 214 patients were included in the demographic analysis. The average age at commencement was 66±14.5 years. The mean urea, calcium, phosphate, and haemoglobin were 27.5±11.5 mmol/L, 2.32±0.21 mmol/L, 1.82±0.52 mmol/L, and 107±14 g/L, respectively. 186 patients had a PD adequacy test recorded. The average 24-hour UV was 1192±665mL at <12 months after commencing PD, 887±592mL and 964±638mL, at 12-24 months and >24 months, respectively. UV was similar between patients who had an episode of peritonitis and those who did not.

Conclusions: With demographic and biochemical data of the SVHM cohort being comparable to the national average, it is possible that high residual UV of our PD cohort may be associated with the better outcomes. We should not underestimate the appeal of using UV in ESRD as a simple, measurable, comparable metric to help guide the commencement of PD if better outcomes can be proven.

Biography:

Rachel Brennan is a Senior Medical Officer in General Medicine and is completing advanced training in Nephrology. Interests include chronic disease management and renal transplant medicine.