Blake PG, Spanner E, McMurray S, Lindasy RM, Ferguson E
The creatinine excretion ratio is an unreliable indicator of
non-compliance in PD patients
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Nov) 6:593 1995
The ratio of total creatinine excretion (dialysate
+ urinary + extrarenal) to predicted creatinine excretion
(from the Cockroft and Gault nomogram) was evaluated
in 43 adult patients. It was previously suggested by others
that if this ratio is greater than 1.24, the patient is playing
"catch up" on the collection day and has recently been non-compliant with his
or her PD prescription.
However, fully 42% of patients had a ratio greater than 1.24
and 9% had a ratio greater than 1.5%, suggesting either a very high
percentage of
non compliance or a lack of applicability of this test to all situations.
Only one patient admitted non compliance and this patient had a ratio of
measured/predicted creatinine exretion of 1.09.
Patients with a high ratio were studied further under controlled and stable
conditions in which non-compliance was effectively ruled out. However, the
measured to predicted creatinine excretion ratio remained elevated.
It was concluded that the
measured/predicted creatinine excretion ratio using the Cockroft estimation
of
creatinine production is an unreliable measure of non compliance in PD
patients.
(Verger)
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Am Soc Nephrol
Basic peritoneal dialysis :
Chronic PD regimens, adequacy, modeling