Comparison of Measured and Predicted Creatinine Excretion is An Unreliable Index of Compliance in Pd Patients
| Autor: | Susan McMurray, Robert M. Lindsay, Evelyn Spanner, Peter G. Blake, Evelyn Ferguson |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
medicine.medical_specialty
Creatinine business.industry medicine.medical_treatment 030232 urology & nephrology Urology General Medicine Peritoneal dialysis Surgery Excretion Compliance (physiology) 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine chemistry Nephrology Ambulatory Lean body mass medicine 030212 general & internal medicine business Prospective cohort study Body mass index |
| Zdroj: | Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis. 16:147-153 |
| ISSN: | 1718-4304 0896-8608 |
| DOI: | 10.1177/089686089601600211 |
| Popis: | Objective To evaluate the use of the ratio of measured to predicted creatinine excretion as an index of compliance in peritoneal dialysis (PD) patients. Design A prospective analysis. Setting Academic teaching hospital dialysis unit. Patients Forty-three patients on PD. Measurements Creatinine excretion in daily dialysate and urine collections was measured on one occasion in 10 patients and on two occasions in 33 patients, and, after adding an estimate for extrarenal creatinine degradation, was divided by predicted creatinine excretion to give a creatinine excretion ratio, which has been proposed as an index of compliance with exchanges in PD patients. Values above 1.24 have been suggested to indicate non-compliance. Lean body mass was also estimated from creatinine excretion. Results The mean creatinine excretion ratio was 1.12, and 30% of patients had a value above 1.3. Only one patient admitted noncompliance. Studies on four consecutive days of guaranteed compliance in 7 patients with high ratios showed that creatinine excretion remained constant, suggesting that the patients were high creatinine producers rather than noncompliant. Creatinine excretion was stable when measured at intervals of days, but over months it tended to change markedly in many patients. Lean body mass estimations using creatinine excretion were low in most patients. Conclusion Comparison of measured and predicted creatinine excretion is not a reliable indicator of noncompliance because many compliant patients consistently excrete more creatinine than predicted. The standard formulas were not validated in dialysis patients and underestimate creatinine excretion significantly in many PD patients. Existing estimates in the literature of non-compliance, using this methodology, may not be accurate. Better methods of detecting this problem are required. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|