The fact that hypoalbuminaemia became insignificant
when RRF was considered in the multivariate
model suggests that there might be an interaction
between RRF and albumin level. To examine this
possibility, we then tested the interaction term of RRF
and serum albumin using a Cox proportional hazard
model. When the interaction term was included in a
multivariate model, there was a significant interaction
between the two variables (P<0.01, data not shown).
This finding implies that serum albumin level is
significantly affected by RRF.
A recent observational study from Hong Kong
found that CAPD patients with diabetes were at
particularly high risk for peritonitis [24], which was
in agreement with our results. Diabetic patients
experienced more peritonitis episodes than nondiabetic
patients (0.63 vs 0.27 episodes per patientyear,
P<0.01). Diabetes was reported to have an
unfavourable effect on migration of phagocytic cells
into the peritoneum, resulting in impaired immunity of
peritoneal defence mechanism [25]. Advanced glycation
end (AGE) products produced in diabetic condition
were also found to be detrimental to phagocytic
activity of peritoneal macrophages [26]. In addition,
bacterial overgrowth in the gastrointestinal tract
appeared to be a contributing factor for peritonitis in
CAPD patients with diabetes [27]. Insulin mixed to
Table 5. Comparison of peritonitis rate and other parameters
according to the baseline GFR
Residual GFR
>5 ml/min/
1.73m2
(n¼107)
5 ml/min/
1.73m2
(n¼97)
Age (years) 55.49.8 52.513.0
Gender (male: female) 65: 42 52: 45
BMI (kg/m2) 23.23.4 21.62.7
DM 37 (34.6%) 34 (35.1%)
Residual GFR
(ml/min/1.73m2)
7.32.2 3.01.2
Peritonitis rate
(episodes per
patient-year)
0.24 0.57
Time to first peritonitis
(months)
28.522.7 20.715.3y
Haemoglobin (g/dl) 10.81.2 10.61.3
BUN (mg/dl) 54.518.4 60.320.6y
Creatinine (mg/dl) 8.22.6 9.82.5
Albumin (g/dl) 3.70.5 3.40.4
Total cholesterol (mg/dl) 179.337.7 178.639.4
Kt/V urea 2.40.5 2.20.4y
Lean body mass
(% body weight)
74.213.3 70.612.1
nPCR (g/kg/day) 1.010.22 0.980.19
P<0.01, yP<0.05 vs patients with residual GFR>5 ml/min/
1.7m2.
2656 S. H. Han et al.
Downloaded from http://ndt.oxfordjournals.org/ by guest on July 18, 2014
การแปล กรุณารอสักครู่..