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PLoS One. 2018 Apr 25;13(4):e0196294. doi: 10.1371/journal.pone.0196294. eCollection 2018.

Survival predictors in anuric patients on peritoneal dialysis: A prospective, multicenter, propensity score-matched cohort study.

Park JY1,2, Cho JH1,2, Jang HM1,2, Kim YS1,3, Kang SW1,4, Yang CW1,5, Kim NH1,6, Choi JY1,2, Park SH1,2, Kim CD1,2, Kim YL1,2.

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Clinical Research Center for End-Stage Renal Disease (CRC for ESRD) in Korea.
School of Medicine, Kyungpook National University, Daegu, Korea.
Seoul National University College of Medicine, Seoul, Korea.
Yonsei University College of Medicine, Seoul, Korea.
Catholic University of Korea College of Medicine, Seoul, Korea.
Chonnam National University Medical School, Gwangju, Korea.


Prevalent anuric peritoneal dialysis (PD) patients usually have higher mortality than PD patients with residual urine volume. We aimed to evaluate the predictors of survival in anuric PD patients. Anuric PD patients (n = 505, <100 mL of daily urine) enrolled in Korean nationwide prospective cohort were analyzed. Survived and non-survived anuric PD patients were compared by propensity score matching analysis with a ratio of two to one. The propensity method was used to adjust for patient age, dialysis duration, and presence of diabetes. Among the total anuric PD patients, non-survived patients showed a significantly older age, higher incidence of diabetes, coronary artery disease, and arrhythmia, and lower serum creatinine and albumin. After propensity score matching, multivariate Cox regression analysis for patient survival showed a decreasing risk as serum albumin increased (HR = 0.347, p = 0.0094). Analysis using the receiver-operating-characteristic (ROC) curve showed that survival could be predicted with a sensitivity of 59.4% and a specificity of 63.2% using a cutoff value of 3.6 g/dL of serum albumin in unmatched total PD patients. The beneficial impact of high albumin level on death was significantly greater for patients with older age (≥50 years), no diabetes, low ultrafiltration (UF) volume (<1000 mL/day), and low levels of serum creatinine (<10 mg/dL), total cholesterol (<177.5 mg/dL), ferritin (<100 ng/mL), and high-sensitivity C-reactive protein (hs-CRP) (<0.1 mg/dL). Survival in anuric PD patients was associated with age, comorbidities, and nutritional factors such as creatinine and albumin. After adjustment by propensity score matching, serum albumin level was an independent predictor for survival in anuric PD patients.

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