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Anuria/diagnóstico , Vasculitis por IgA/diagnóstico , Anuria/sangre , Anuria/etiología , Anuria/orina , Niño , Diagnóstico Diferencial , Humanos , Vasculitis por IgA/sangre , Vasculitis por IgA/complicaciones , Vasculitis por IgA/orina , Masculino , Metilprednisolona/administración & dosificación , Ultrasonografía , Uréter/diagnóstico por imagenAsunto(s)
Anuria/inmunología , Glomerulonefritis por IGA/inmunología , Vasculitis por IgA/complicaciones , Metilprednisolona/administración & dosificación , Obstrucción Ureteral/inmunología , Anuria/diagnóstico , Anuria/tratamiento farmacológico , Niño , Diagnóstico Diferencial , Glomerulonefritis por IGA/complicaciones , Glomerulonefritis por IGA/diagnóstico , Glomerulonefritis por IGA/tratamiento farmacológico , Humanos , Vasculitis por IgA/diagnóstico , Vasculitis por IgA/inmunología , Masculino , Resultado del Tratamiento , Ultrasonografía , Uréter/diagnóstico por imagen , Uréter/efectos de los fármacos , Uréter/inmunología , Obstrucción Ureteral/complicaciones , Obstrucción Ureteral/diagnóstico , Obstrucción Ureteral/tratamiento farmacológicoRESUMEN
Retrograde pyelography (RGP) is done to evaluate the collecting system when intravenous contrast studies are contraindicated due to renal insufficiency or prior adverse reactions. We report a patient who developed acute renal shutdown following bilateral RGP in the same sitting done for evaluation of positive malignant cytology of urine. A 65-year-old man on treatment for left stroke and hypertension, with a baseline serum creatinine of 1.9 mg/dl presented with painless haematuria for 2 months. Plain computed tomogram revealed a small papillary growth on the posterior wall of the urinary bladder. Transurethral resection revealed inflammatory atypia. As the patient continued to have haematuria, he was taken up for bilateral ureteric washings for cytology and bilateral RGP. A 5-Fr universal ureteral catheter was used to cannulate the ureters, urine was aspirated for cytology and 6 ml of 76% meglumine diatrizoate (1:2) was injected, and sufficient opacification with no abnormality or pyelosinus/venous or lymphatic reflux was noted. In the immediate postoperative period, he developed anuria and the serum creatinine rose to 3.6 mg/dl on postoperative day 1 and to 7.5 mg/dl on day 5. He needed three sessions of haemodialysis. Ultrasonography showed no hydroureteronephrosis. Urine output improved and his serum creatinine stabilized at the preoperative level of 1.8 mg/dl. The patient is doing well with stable renal function at 12 months. Although RGP is useful, it needs to be done with caution if a bilateral procedure is contemplated. This entity is seldom reported, and routine double-J stenting following unilateral/bilateral RGP also needs evaluation.
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Anuria/etiología , Obstrucción Ureteral/diagnóstico por imagen , Neoplasias de la Vejiga Urinaria/complicaciones , Urografía/efectos adversos , Anciano , Anuria/diagnóstico , Anuria/terapia , Humanos , Riñón/diagnóstico por imagen , Masculino , Diálisis Renal , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Ultrasonografía , Uréter/diagnóstico por imagen , Obstrucción Ureteral/etiología , Neoplasias de la Vejiga Urinaria/diagnóstico por imagen , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/cirugíaAsunto(s)
Lesión Renal Aguda/diagnóstico , Anuria/diagnóstico , Corteza Renal/patología , Médula Renal/patología , Choque Séptico/complicaciones , Lesión Renal Aguda/etiología , Lesión Renal Aguda/patología , Lesión Renal Aguda/terapia , Adulto , Anuria/etiología , Anuria/patología , Anuria/terapia , Femenino , Humanos , Corteza Renal/diagnóstico por imagen , Médula Renal/diagnóstico por imagen , Necrosis/etiología , Necrosis/patología , Diálisis RenalRESUMEN
No disponible
Asunto(s)
Humanos , Femenino , Anciano de 80 o más Años , Anuria/diagnóstico , Astenia/diagnóstico , Ertapenem/administración & dosificación , Diuresis , Orina/química , Infecciones Urinarias/microbiología , Carmin de Índigo/orina , Klebsiella pneumoniae/aislamiento & purificación , Infecciones Urinarias/diagnóstico , Anuria/complicacionesRESUMEN
INTRODUCTION: Psychic anuria is an old term, referring to a very rare psycho-urological event that has scarcely been studied so far. MATERIALS AND METHODS: A retrospective study of the patients with psychic anuria presented to Assiut Urology and Nephrology Hospital during the period July 1991-June 2016 was done. Psychic anuria was defined, and the demographic and clinical characteristics including the methods of diagnosis and management were studied. RESULTS: Of more than 3,800 cases of anuria, 9 female patients (0.24%) experienced psychic anuria in the age range of 17-43 years. Cardinal clinical findings included anuria for 36-72 h with absence of organic causes and normal renal function tests. Psychosocial risk factors were reported in the 9 cases. Anuria was documented by reliable history (56%) or observable urine collection (44%). Diagnosis was done by exclusion, where the investigations revealed no organic causes. Seven cases responded to the placebo intervention and 2 cases were self-limiting and resolved spontaneously. CONCLUSIONS: Psychic anuria is an extremely rare urological emergency that presents, mainly, in young adult females with unknown mechanisms. Renal vasoconstriction following psychosocial stressors is suggested. It is diagnosed by exclusion and resolves spontaneously or responds to placebo intervention as a mental distraction technique.
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Anuria/diagnóstico , Anuria/psicología , Trastornos Psicofisiológicos/diagnóstico , Trastornos Psicofisiológicos/psicología , Adolescente , Adulto , Anuria/epidemiología , Femenino , Humanos , Riñón/patología , Pruebas de Función Renal , Trastornos Psicofisiológicos/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Centros de Atención Terciaria , Urología , Vasoconstricción , Adulto JovenAsunto(s)
Lesión Renal Aguda/etiología , Anuria/etiología , Presión Sanguínea , Hipertensión/etiología , Infarto/etiología , Médula Renal/irrigación sanguínea , Arteritis de Takayasu/complicaciones , Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/fisiopatología , Adulto , Anuria/diagnóstico , Anuria/fisiopatología , Aortografía/métodos , Biopsia , Angiografía por Tomografía Computarizada , Femenino , Humanos , Hipertensión/diagnóstico , Hipertensión/fisiopatología , Infarto/diagnóstico , Infarto/fisiopatología , Factores de Riesgo , Arteritis de Takayasu/diagnóstico por imagenAsunto(s)
Anuria , Gastroenteritis , Necrosis Papilar Renal/diagnóstico , Infecciones por Rotavirus , Obstrucción Ureteral/diagnóstico , Ureteroscopía , Anuria/diagnóstico , Anuria/etiología , Diagnóstico Diferencial , Gastroenteritis/complicaciones , Gastroenteritis/diagnóstico , Gastroenteritis/metabolismo , Humanos , Lactante , Masculino , Rotavirus/aislamiento & purificación , Infecciones por Rotavirus/complicaciones , Infecciones por Rotavirus/diagnóstico , Infecciones por Rotavirus/metabolismo , Stents , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento , Ultrasonografía/métodos , Obstrucción Ureteral/etiología , Ureteroscopía/instrumentación , Ureteroscopía/métodos , Ácido Úrico/metabolismo , Cálculos Urinarios/químicaAsunto(s)
Acetazolamida/efectos adversos , Lesión Renal Aguda/complicaciones , Anuria/etiología , Acetazolamida/administración & dosificación , Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/orina , Administración Oral , Anuria/diagnóstico , Anuria/orina , Inhibidores de Anhidrasa Carbónica/administración & dosificación , Inhibidores de Anhidrasa Carbónica/efectos adversos , Diagnóstico Diferencial , Relación Dosis-Respuesta a Droga , Humanos , Masculino , Persona de Mediana EdadRESUMEN
INTRODUCTION: This study tests the hypothesis that renal tissue oxygen saturation as measured by Near Infrared Spectroscopy (NIRS) would correlate with urine output in neonates with congenital diaphragmatic hernia (CDH) on extracorporeal membrane oxygenation (ECMO). METHODS: Between 2012 and 2015, neonates with CDH were enrolled as part of a comprehensive study that provided renal/cerebral/abdominal NIRS monitoring for the duration of ECMO support. Continuous NIRS measurements, mean arterial pressure, and urine output were recorded. Periods of anuria (NU), adequate urine output >1ml/kg/h (AU), and low urine output <1ml/kg/h (LU) were noted and analyzed. RESULTS: Over 1500h of continuous renal NIRS were obtained from six neonates. NIRS values were significantly different during periods of AU, LU, and anuria (84±6%, 76±3%, and 67±6%, p<0.01). ROC curves identified NIRS >76% as highly predictive of adequate urine output (AUC=0.96). MAP was significantly lower only in anuric patients, 36.42±10.26, compared to patients with AU and LU - 42.99±5.25 and 42.85±7.4, respectively (p<0.001). CONCLUSION: Renal NIRS measurements correlate with urine production. Lower values are noted as urine output declines and precedes a decline in MAP. Renal NIRS may have promise as a non-invasive means of determining adequacy of renal perfusion and urine output in neonates with complex fluid shifts. LEVEL OF EVIDENCE: IIb.
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Anuria/etiología , Oxigenación por Membrana Extracorpórea , Hernias Diafragmáticas Congénitas/terapia , Riñón/diagnóstico por imagen , Oxígeno/metabolismo , Espectroscopía Infrarroja Corta , Anuria/diagnóstico , Anuria/metabolismo , Biomarcadores/metabolismo , Femenino , Hernias Diafragmáticas Congénitas/complicaciones , Hernias Diafragmáticas Congénitas/metabolismo , Hernias Diafragmáticas Congénitas/orina , Humanos , Recién Nacido , Riñón/metabolismo , Masculino , Curva ROC , Estudios Retrospectivos , Método Simple Ciego , Resultado del TratamientoRESUMEN
Hyponatraemia-induced rhabdomyolysis is a rare, but reported phenomenon, particularly in patients with chronic schizophrenia on depot antipsychotics prone to psychogenic polydipsia. To the best of our knowledge, there are no reported cases of hyponatraemia-induced rhabdomyolysis complicated by oligo-anuric acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT). The initiation of CRRT is complicated in severe hyponatraemia, predominantly due to the need to avoid rapid changes in tonicity associated with rapid changes in sodium. We report a case of severe hyponatraemia (104â mmol/L) complicated by oligo-anuric rhabdomyolysis-induced AKI and our management of the renal prescription.
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Lesión Renal Aguda/complicaciones , Anuria/etiología , Hiponatremia/complicaciones , Terapia de Reemplazo Renal/métodos , Rabdomiólisis/complicaciones , Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/terapia , Anuria/diagnóstico , Anuria/terapia , Humanos , Masculino , Persona de Mediana Edad , Rabdomiólisis/diagnóstico , Rabdomiólisis/etiologíaRESUMEN
Few studies have been reported on alterations of trace elements (TE) in peritoneal dialysis patients. Our objective was to investigate and assess the characteristics of daily TE excretions in continuous ambulatory peritoneal dialysis (CAPD) patients. This cross-sectional study included 61 CAPD patients (nonanuric/anuric: 45/16) and 11 healthy subjects in Wuhan, China between 2013 and 2014. The dialysate and urine of patients and urine of healthy subjects were collected. The concentrations of copper (Cu), zinc (Zn), selenium (Se), molybdenum (Mo), and arsenic (As) in dialysate and urine were determined using inductively coupled plasma mass spectrometer (ICP-MS). Various clinical variables were obtained from automatic biochemical analyzer. Daily Cu, Zn, Se, and Mo excretions in nonanuric patients were higher than healthy subjects, while arsenic excretion in anuric patients was lower. A strong and positive correlation was observed between Se and Mo excretion in both dialysate (ß = 0.869, p < 0.010) and urine (ß = 0.968, p < 0.010). Furthermore, the clinical variables associated with Se excretion were found to be correlated with Mo excretion. Our findings indicated that nonanuric CAPD patients may suffer from deficiency of some essential TEs, while anuric patients are at risk of arsenic accumulation. A close association between Se and Mo excretion was also found.
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Anuria/terapia , Diálisis Peritoneal Ambulatoria Continua , Oligoelementos/orina , Adulto , Anciano , Anuria/complicaciones , Anuria/diagnóstico , Anuria/orina , Arsénico/orina , Biomarcadores/orina , Estudios de Casos y Controles , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Molibdeno/orina , Estado Nutricional , Diálisis Peritoneal Ambulatoria Continua/efectos adversos , Selenio/orina , Resultado del Tratamiento , Urinálisis , Adulto JovenRESUMEN
Histopathological findings can play an important role in the management of atypical haemolytic uraemic syndrome (aHUS). We report a case of aHUS that did not recover from anuria, despite the administration of eculizumab, with impressive histopathological findings. A 3-month-old girl was admitted because of poor feeding, vomiting, and diarrhoea without haemorrhage. She had anuria and severe hypertension, and laboratory results showed haemolytic anaemia with schizocytes, thrombocytopenia, and renal impairment. Although no mutations in the complement system or diacylglycerol kinase epsilon were detected, she was diagnosed with aHUS owing to the clinical course and by the exclusion of Escherichia coli infection and thrombotic thrombocytopenic purpura. Plasma exchange was performed once at day 2 and eculizumab therapy was started from day 18, with a severe infusion reaction at the first administration. After the initiation of eculizumab, although the serum lactate dehydrogenase level improved gradually, she did not recover from anuria. Pathological findings of the kidney biopsy at day 37 included diffuse arteriolar and arterial luminal stenosis with remarkable thickness and sclerotic changes of the media and intima, which are suggestive of aHUS. In addition, most glomeruli had global sclerosis and were collapsed, and 80% of the tubulointerstitial compartment showed atrophic changes with infiltration of inflammatory cells. The present case is possibly a kidney-specific fulminant type of aHUS. Although showing efficacy against thrombotic microangiopathy, eculizumab did not improve kidney function. The pathological findings reflected the severe and irreversible kidney injury.
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Lesión Renal Aguda/etiología , Anticuerpos Monoclonales Humanizados/uso terapéutico , Anuria/etiología , Síndrome Hemolítico Urémico Atípico/tratamiento farmacológico , Inmunosupresores/uso terapéutico , Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/terapia , Anuria/diagnóstico , Anuria/terapia , Síndrome Hemolítico Urémico Atípico/diagnóstico , Biopsia , Terapia Combinada , Femenino , Humanos , Lactante , Diálisis Peritoneal , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
Acute suprarenal aortic occlusion is a rare but often catastrophic event. Despite immediate treatment, mortality and morbidity are high. We present a case of acute suprarenal aortic occlusion presenting with renal failure and dyspnea but without lower limb ischemia. Diagnosis was initially not taken in consideration. The patient required hemodialysis and temporary mechanical ventilation. After 13 days, an abdominal ultrasound was performed which revealed thrombosis of the suprarenal abdominal aorta. Suprarenal aortic thrombectomy was performed followed by aortobi-iliac bypass grafting. Diuresis returned 4 hr after surgery, and the patient fully recovered. Thorough review of the literature revealed only 8 cases of acute suprarenal aortic occlusion. Only 3 patients survived. To our knowledge, this is the first reported case of acute suprarenal occlusion, in which renal function could be restored after a 14-day period of anuria. The case illustrates that in select cases with prolonged acute renal failure aortorenal revascularization can be performed successfully.
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Lesión Renal Aguda/terapia , Anuria/terapia , Aorta Abdominal , Trombosis/cirugía , Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/etiología , Anciano , Anuria/diagnóstico , Anuria/etiología , Femenino , Humanos , Trombectomía , Trombosis/complicaciones , Trombosis/diagnósticoRESUMEN
Renal involvement in Waldenström's macroglobulinaemia (WM) is very unusual when compared to multiple myeloma. We report a case of a patient who developed anuric acute kidney injury secondary to cast nephropathy, dependent on high-flux haemodialysis. Complementary study revealed the presence of blood IgM monoclonal gammopathy and a massive bone marrow lymphoplasmacytic infiltration. There were no osteolytic lesions and no clinical signs/symptoms of hyperviscosity syndrome. The diagnosis of WM was established and a dexamethasone plus cyclophosphamide regime was started, in addition to plasmapheresis. The patient partially recovered renal function allowing haemodialysis and plasmapheresis withdrawal. He remained asymptomatic with a good response to chemotherapy and 12â months after his renal function remained stable. This is a rare clinical case in which WM presented as an IgM cast nephropathy, which in turn is an extremely rare renal presentation of this equally rare haematological disorder.
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Enfermedades Renales/diagnóstico , Macroglobulinemia de Waldenström/diagnóstico , Anciano de 80 o más Años , Anuria/diagnóstico , Anuria/metabolismo , Humanos , Enfermedades Renales/metabolismo , Enfermedades Renales/patología , Masculino , Enfermedades Raras , Macroglobulinemia de Waldenström/metabolismo , Macroglobulinemia de Waldenström/patologíaRESUMEN
BACKGROUND: Similar to other Gulf countries, the society in United Arab Emirates is pro-natal with high parity and high prevalence of macrosomic babies. Therefore, it is possible to have a high prevalence of pelvic organ prolapse (POP). Thus, the aim of this study was to determine the prevalence of POP symptoms in one of the UAE cities. METHODS: A cross-sectional study of all women who attended the three family development centres was conducted in Al-Ain from January 2010 to January 2011. Non-Emirati, pregnant and nulliparous women younger than 30 years were excluded. RESULTS: Out of 482 women who met the inclusion criteria, 429 (89.0%) agreed to fully participate in the study. 127 women (29.6%) reported symptoms of POP (mean age: 38.2 years, range: 18-71). Out of the 127 affected women, a dragging lump was felt occasionally in 68%, sometimes in 19%, most of times in 9% and all the times in 4%. 73% of affected women experienced soreness in the vagina. Around one third had to insert their fingers in the vagina to either start or complete emptying of the bladder or to empty the bowel. Using multivariate analysis, the independent risk factors were history of constipation, level of education, chronic chest disease, nature of occupation, birth weight and body mass index (Odds ratio; 95% Confidence interval): (4.1; 2.3-7.3), (1.7; 1.2-2.3), (2.9; 1.6-5.5), (0.5; 0.4-0.8), (1.7; 1.1-2.5), (1.1; 1.0-1.1), respectively (P < 0.05 for all). CONCLUSION: Symptoms of POP are prevalent among Emirati women. Independent risk factors included history of chronic constipation and chest disease, level of education, job type, birth weight and body mass index. Additional healthcare campaigns are required to educate the public regarding these risk factors.
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Anuria/epidemiología , Estreñimiento/epidemiología , Prolapso de Órgano Pélvico/diagnóstico , Prolapso de Órgano Pélvico/epidemiología , Evaluación de Síntomas/estadística & datos numéricos , Salud de la Mujer/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anuria/diagnóstico , Índice de Masa Corporal , Comorbilidad , Estreñimiento/diagnóstico , Estudios Transversales , Escolaridad , Empleo/estadística & datos numéricos , Femenino , Humanos , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Índice de Severidad de la Enfermedad , Emiratos Árabes Unidos/epidemiología , Adulto JovenRESUMEN
Here, we report a case of focal segmental glomerular sclerosis (FSGS) recurrence immediately (47 minutes) after transplantation. A 1-hour biopsy specimen showed large periodic acid-Schiff-positive granules within the cells of the swollen proximal tubule, while electron microscopy revealed podocyte swelling and partial foot process effacement. These findings were worse on day 2 biopsy. Massive proteinuria and anuria were then observed. Two courses (2 × 2 times) of plasmapheresis and rituximab were administered, and the graft function gradually recovered. A day 22 biopsy specimen showed improvement in findings compared to those observed on day 2. One year after transplantation, no signs of FSGS recurrence are evident, and graft function remains good.
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Anuria/etiología , Glomeruloesclerosis Focal y Segmentaria/cirugía , Trasplante de Riñón/efectos adversos , Riñón/patología , Proteinuria/etiología , Anuria/diagnóstico , Anuria/fisiopatología , Anuria/terapia , Biopsia , Femenino , Glomeruloesclerosis Focal y Segmentaria/diagnóstico , Supervivencia de Injerto , Humanos , Inmunosupresores/uso terapéutico , Riñón/efectos de los fármacos , Riñón/fisiopatología , Riñón/ultraestructura , Túbulos Renales Proximales/patología , Microscopía Electrónica , Persona de Mediana Edad , Plasmaféresis , Podocitos/ultraestructura , Proteinuria/diagnóstico , Proteinuria/fisiopatología , Proteinuria/terapia , Recuperación de la Función , Recurrencia , Rituximab/uso terapéutico , Factores de Tiempo , Resultado del TratamientoRESUMEN
INTRODUCTION: The aim of this study was to evaluate the incidence and determinants of AKI in a large cohort of cardiac arrest patients. METHODS: We reviewed all patients admitted, for at least 48 hours, to our Dept. of Intensive Care after CA between January 2008 and October 2012. AKI was defined as oligo-anuria (daily urine output <0.5 ml/kg/h) and/or an increase in serum creatinine (≥0.3 mg/dl from admission value within 48 hours or a 1.5 time from baseline level). Demographics, comorbidities, CA details, and ICU interventions were recorded. Neurological outcome was assessed at 3 months using the Cerebral Performance Category scale (CPC 1-2 = favorable outcome; 3-5 = poor outcome). RESULTS: A total of 199 patients were included, 85 (43%) of whom developed AKI during the ICU stay. Independent predictors of AKI development were older age, chronic renal disease, higher dose of epinephrine, in-hospital CA, presence of shock during the ICU stay, a low creatinine clearance (CrCl) on admission and a high cumulative fluid balance at 48 hours. Patients with AKI had higher hospital mortality (55/85 vs. 57/114, p = 0.04), but AKI was not an independent predictor of poor 3-month neurological outcome. CONCLUSIONS: AKI occurred in more than 40% of patients after CA. These patients had more severe hemodynamic impairment and needed more aggressive ICU therapy; however the development of AKI did not influence neurological recovery.
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Lesión Renal Aguda/etiología , Paro Cardíaco/complicaciones , Mortalidad Hospitalaria , Lesión Renal Aguda/epidemiología , Lesión Renal Aguda/terapia , Anuria/diagnóstico , Paro Cardíaco/epidemiología , Paro Cardíaco/mortalidad , Paro Cardíaco/terapia , Humanos , Unidades de Cuidados Intensivos , Tiempo de Internación , Oliguria/diagnóstico , Estudios RetrospectivosAsunto(s)
Anuria/etiología , Glomerulonefritis Membranoproliferativa/etiología , Necrosis Tubular Aguda/etiología , Insuficiencia Renal/etiología , Macroglobulinemia de Waldenström/complicaciones , Anciano , Anuria/diagnóstico , Anuria/terapia , Biomarcadores/sangre , Biopsia , Creatinina/sangre , Glomerulonefritis Membranoproliferativa/diagnóstico , Glomerulonefritis Membranoproliferativa/terapia , Hematuria/etiología , Humanos , Necrosis Tubular Aguda/diagnóstico , Necrosis Tubular Aguda/terapia , Masculino , Valor Predictivo de las Pruebas , Insuficiencia Renal/diagnóstico , Insuficiencia Renal/terapia , Macroglobulinemia de Waldenström/diagnóstico , Macroglobulinemia de Waldenström/terapiaRESUMEN
BACKGROUND: Residual renal function (RRF) is pivotal to long-term outcomes, while rapid RRF decline (RRFD) is associated with mortality risk for continuous ambulatory peritoneal dialysis (CAPD) patients. This study was conducted to compare the impact of "initial anuria" and rapid RRFD on the long-term prognosis of CAPD patients. METHOD: According to the timing of anuria and the slope of RRFD, a total of 255 incident CAPD patients were divided into 3 groups. For the "anuria" group, anuria was detected from CAPD initiation and persisted for > 6 months (n = 27). Based on the median of the RRFD slope, the other 228 non-anuric patients were divided into a "slow decliner" group (n = 114), and a "rapid decliner" group (n = 114). The maximal observation period was 120 months. RESULTS: Logistic regression tests indicated that the "anuria" group was associated with previous hemodialysis > 3 months (odds ratio [OR]: 8.52, 95% confidence interval [CI]: 3.12 - 23.28), and female (OR: 0.29, 95% CI: 0.09 - 0.90), while the "fast decliner" group with higher Davies co-morbidity scores (DCS) (OR: 1.52; 95% CI: 1.08 - 2.14), body mass index (BMI) (OR: 1.12; 95% CI: 1.04 - 1.21), and male (OR: 1.12; 95% CI: 1.04 - 1.21). After adjusting for DCS, the "fast decliner" group (hazard ratio [HR]: 0.37; 95% CI: 0.17 - 0.80) showed a better outcome than that of the "anuria" group (reference = 1). Both baseline RRF (ß = -0.24; p < 0.001) and DCS (ß = -3.76; p < 0.001) showed inverse linear correlations to the slope of RRFD. From the Cox proportional analyses, higher baseline RRF (HR: 0.92; 95% CI: 0.88 -.97) and higher slope of RRFD (slower decline in RRF) (HR: 0.90; 95% CI: 0.85 - 0.96) were independent factors for less mortality risk in patients with DCS = 0. However, only a higher slope of RRFD (HR: 0.97; 95% CI: 0.94 - 0.99) was significant for better survival in CAPD patients with DCS > 0. CONCLUSION: Compared to the baseline RRF, CAPD patients with co-morbidities that rapidly deteriorate RRFD are more crucially associated with long-term mortality risk.