MỐI LIÊN QUAN GIỮA CHỨC NĂNG THẬN TỒN LƯU VÀ ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG Ở BỆNH NHÂN LỌC MÀNG BỤNG LIÊN TỤC NGOẠI TRÚ TẠI BỆNH VIỆN CHỢ RẪY

Abstract

Background: Residual kidney function (RKF) is an important factor associated with clinical characteristics, laboratory parameters, and treatment in patients with end-stage kidney disease (ESKD) on peritoneal dialysis (PD). Objectives: 1) To evaluate residual kidney function and (2) to investigate the association between RKF and selected clinical and laboratory characteristics in Continuous Ambulatory Peritoneal Dialysis (CAPD) patients. Subjects and Methods: A cross-sectional descriptive study was conducted in patients with ESKD receiving CAPD who attended regular follow-up visits at the Peritoneal Dialysis Clinic, Department of Nephrology, Cho Ray Hospital, from January 2025 to April 2025. Results: A total of 93 patients were enrolled, with a median age of 41 years; 48 patients were female (61.6%). The median duration of PD was 35 months. Most patients had hypertension (98.9%); 22.6% had atherosclerotic cardiovascular disease, and 6.5% had diabetes mellitus. The median RKF was 0.1 [0–1.5] mL/min/1.73 m²; 38.7% of patients had preserved RKF, while 61.3% had loss of RKF. The median 24-hour urine volume was 100 mL; patients with preserved RKF had significantly higher urine output (700 vs. 0 mL; p<0.001), and a very strong positive correlation was observed between RKF and 24-hour urine volume (rho = +0.922; p<0.001). Patients with loss of RKF had a longer median PD duration (43.0 vs. 19.5 months; p<0.001), a higher prevalence of prior peritonitis (64.9% vs. 16.7%; p<0.001), and a higher rate of hypertonic dialysate use (82.5% vs. 33.3%; p<0.001). In addition, these patients had lower total Kt/V (1.7 vs. 2.2; p<0.001), lower hemoglobin levels (10.0 vs. 10.5 g/dL; p=0.043) and lower serum albumin levels (p=0.015). RKF was negatively correlated with PD duration, number of peritonitis episodes, and 24-hour ultrafiltration volume, and positively correlated with total Kt/V, total creatinine clearance, hemoglobin, and serum albumin. Conclusions: The proportion of CAPD patients maintaining RKF at Cho Ray Hospital was low. RKF was closely associated with a history of peritonitis, use of hypertonic dialysate, peritoneal dialysis adequacy, and inflammatory–nutritional parameters.