{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T14:42:27Z","timestamp":1786372947014,"version":"build-2736575974"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01 DK107931"],"award-info":[{"award-number":["R01 DK107931"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01 DK 103986"],"award-info":[{"award-number":["R01 DK 103986"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011751","name":"Northwest Kidney Centers","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011751","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001463","name":"American Society of Nephrology","doi-asserted-by":"publisher","award":["Ben J. Lipps Research Fellowship"],"award-info":[{"award-number":["Ben J. Lipps Research Fellowship"]}],"id":[{"id":"10.13039\/100001463","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Residual kidney function is important to the health and wellbeing of patients with ESKD. We tested whether the kidney clearances of proximal tubular secretory solutes are associated with burden of uremic and heart failure symptoms among patients on peritoneal dialysis with residual kidney function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting, participants, &amp; measurements<\/jats:title>\n                    <jats:p>\n                      We enrolled 29 patients on incident peritoneal dialysis with residual urine output &gt;250 ml daily. We used targeted liquid chromatography-mass spectrometry to quantify plasma, 24-hour urine, and peritoneal dialysate concentrations of ten tubular secretory solutes. We calculated the kidney and peritoneal dialysis clearances of each secretory solute, creatinine, and urea, and we estimated a composite kidney and peritoneal secretion score. We assessed for uremic symptoms using the Dialysis Symptom Index and heart failure\u2013related symptoms using the Kansas City Cardiomyopathy Questionnaire. We used linear regression to determine associations of composite secretory solute clearances and GFR\n                      <jats:sub>urea+Cr<\/jats:sub>\n                      with Dialysis Symptom Index symptom score and Kansas City Cardiomyopathy Questionnaire summary score.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean residual kidney clearances of creatinine and urea were 8\u00b15 and 9\u00b16 ml\/min per 1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      , respectively, and mean GFR\n                      <jats:sub>urea+Cr<\/jats:sub>\n                      was 8\u00b15 ml\/min per 1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      . The residual kidney clearances of most secretory solutes were considerably higher than creatinine and urea clearance, and also, they were higher than their respective peritoneal dialysis clearances. After adjustments for age and sex, each SD higher composite kidney secretion score was associated with an 11-point lower Dialysis Symptom Index score (95% confidence interval, \u221220 to \u22121;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.03) and a 12-point higher Kansas City Cardiomyopathy Questionnaire score (95% confidence interval, 0.5- to 23-point higher score;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.04). Composite peritoneal dialysis secretion score was not associated with either symptom assessment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Residual kidney clearances of secretory solutes are higher than peritoneal dialysis clearances. Kidney clearances of secretory solutes are associated with patient-reported uremic and heart failure\u2013related symptoms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.11120919","type":"journal-article","created":{"date-parts":[[2020,3,9]],"date-time":"2020-03-09T14:55:15Z","timestamp":1583765715000},"page":"530-538","source":"Crossref","is-referenced-by-count":9,"title":["Association of Tubular Solute Clearance with Symptom Burden in Incident Peritoneal Dialysis"],"prefix":"10.2215","volume":"15","author":[{"given":"Ke","family":"Wang","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Washington, Seattle Washington;"},{"name":"Division of Nephrology, Department of Medicine, University of Washington, Kidney Research Institute, Seattle, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Washington, Kidney Research Institute, Seattle, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Washington, Kidney Research Institute, Seattle, Washington;"},{"name":"Department of Epidemiology, University of Washington, Seattle Washington; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew N.","family":"Hoofnagle","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Washington, Kidney Research Institute, Seattle, Washington;"},{"name":"Department of Laboratory Medicine, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica O.","family":"Becker","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8461-5111","authenticated-orcid":false,"given":"Leila R.","family":"Zelnick","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Washington, Seattle Washington;"},{"name":"Division of Nephrology, Department of Medicine, University of Washington, Kidney Research Institute, Seattle, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Kundzins","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Washington, Kidney Research Institute, Seattle, Washington;"},{"name":"Department of Epidemiology, University of Washington, Seattle Washington; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Goodling","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Washington, Kidney Research Institute, Seattle, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Himmelfarb","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Washington, Seattle Washington;"},{"name":"Division of Nephrology, Department of Medicine, University of Washington, Kidney Research Institute, Seattle, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"Kestenbaum","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Washington, Seattle Washington;"},{"name":"Division of Nephrology, Department of Medicine, University of Washington, Kidney Research Institute, Seattle, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,3,9]]},"reference":[{"key":"B1-20230813","doi-asserted-by":"crossref","first-page":"2158","DOI":"10.1681\/ASN.V12102158","article-title":"Relative contribution of residual renal function and peritoneal clearance to adequacy of dialysis: A reanalysis of the CANUSA study","volume":"12","author":"Bargman","year":"2001","journal-title":"J Am Soc Nephrol"},{"key":"B2-20230813","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1016\/S0272-6386(03)00362-7","article-title":"The relative importance of residual renal function compared with peritoneal clearance for patient survival and quality of life: An analysis of the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD )-2","volume":"41","author":"Termorshuizen","year":"2003","journal-title":"Am J Kidney Dis"},{"key":"B3-20230813","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1097\/01.ASN.0000117976.29592.93","article-title":"Relative contribution of residual renal function and different measures of adequacy to survival in hemodialysis patients: An analysis of the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD)-2","volume":"15","author":"Termorshuizen","year":"2004","journal-title":"J Am Soc Nephrol"},{"key":"B4-20230813","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1053\/j.ajkd.2010.03.020","article-title":"Association of residual urine output with mortality, quality of life, and inflammation in incident hemodialysis patients: The Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) Study","volume":"56","author":"Shafi","year":"2010","journal-title":"Am J Kidney Dis"},{"key":"B5-20230813","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1053\/ajkd.2001.25198","article-title":"Residual renal function and mortality risk in hemodialysis patients","volume":"38","author":"Shemin","year":"2001","journal-title":"Am J Kidney Dis"},{"key":"B6-20230813","doi-asserted-by":"crossref","first-page":"1726","DOI":"10.1038\/sj.ki.5000382","article-title":"The importance of residual renal function in dialysis patients","volume":"69","author":"Wang","year":"2006","journal-title":"Kidney Int"},{"key":"B7-20230813","doi-asserted-by":"crossref","first-page":"2274","DOI":"10.1093\/ndt\/10.12.2274","article-title":"Time course of inulin and creatinine clearance in the interval between two haemodialysis treatments","volume":"10","author":"van Olden","year":"1995","journal-title":"Nephrol Dial Transplant"},{"key":"B8-20230813","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1681\/ASN.V75745","article-title":"Measurement of residual renal function in patients treated with continuous ambulatory peritoneal dialysis","volume":"7","author":"van Olden","year":"1996","journal-title":"J Am Soc Nephrol"},{"key":"B9-20230813","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1038\/ki.2013.154","article-title":"Numerous protein-bound solutes are cleared by the kidney with high efficiency","volume":"84","author":"Sirich","year":"2013","journal-title":"Kidney Int"},{"key":"B10-20230813","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1681\/ASN.2013060597","article-title":"Prominent accumulation in hemodialysis patients of solutes normally cleared by tubular secretion","volume":"25","author":"Sirich","year":"2014","journal-title":"J Am Soc Nephrol"},{"key":"B11-20230813","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.semnephrol.2014.02.004","article-title":"Protein-bound molecules: A large family with a bad character","volume":"34","author":"Sirich","year":"2014","journal-title":"Semin Nephrol"},{"key":"B12-20230813","doi-asserted-by":"crossref","first-page":"2842","DOI":"10.1021\/pr200093w","article-title":"Untargeted metabolomics identifies enterobiome metabolites and putative uremic toxins as substrates of organic anion transporter 1 (Oat1)","volume":"10","author":"Wikoff","year":"2011","journal-title":"J Proteome Res"},{"key":"B13-20230813","doi-asserted-by":"crossref","first-page":"4939","DOI":"10.1038\/s41598-017-04949-2","article-title":"Key role for the organic anion transporters, OAT1 and OAT3, in the in vivo handling of uremic toxins and solutes","volume":"7","author":"Wu","year":"2017","journal-title":"Sci Rep"},{"key":"B14-20230813","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1681\/ASN.2011121175","article-title":"Normal and pathologic concentrations of uremic toxins","volume":"23","author":"Duranton","year":"2012","journal-title":"J Am Soc Nephrol"},{"key":"B15-20230813","doi-asserted-by":"crossref","first-page":"1760","DOI":"10.1046\/j.1523-1755.2002.00318.x","article-title":"Major role of organic anion transporter 3 in the transport of indoxyl sulfate in the kidney","volume":"61","author":"Deguchi","year":"2002","journal-title":"Kidney Int"},{"key":"B16-20230813","doi-asserted-by":"crossref","first-page":"2498","DOI":"10.1093\/ndt\/gfq785","article-title":"Organic anion transporters play an important role in the uptake of p-cresyl sulfate, a uremic toxin, in the kidney","volume":"26","author":"Miyamoto","year":"2011","journal-title":"Nephrol Dial Transplant"},{"key":"B17-20230813","doi-asserted-by":"crossref","first-page":"1841","DOI":"10.1007\/s00216-012-5929-3","article-title":"Protein-bound uremic toxins in hemodialysis patients measured by liquid chromatography\/tandem mass spectrometry and their effects on endothelial ROS production","volume":"403","author":"Itoh","year":"2012","journal-title":"Anal Bioanal Chem"},{"key":"B18-20230813","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1124\/jpet.105.085613","article-title":"Renal clearance of endogenous hippurate correlates with expression levels of renal organic anion transporters in uremic rats","volume":"314","author":"Deguchi","year":"2005","journal-title":"J Pharmacol Exp Ther"},{"key":"B19-20230813","doi-asserted-by":"crossref","first-page":"2148","DOI":"10.1681\/ASN.2014121193","article-title":"Tubular Secretion in CKD","volume":"27","author":"Suchy-Dicey","year":"2016","journal-title":"J Am Soc Nephrol"},{"key":"B20-20230813","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1373\/clinchem.2016.260117","article-title":"Diurnal and long-term variation in plasma concentrations and renal clearances of circulating markers of kidney proximal tubular secretion","volume":"63","author":"Rivara","year":"2017","journal-title":"Clin Chem"},{"key":"B21-20230813","doi-asserted-by":"crossref","first-page":"14455","DOI":"10.1016\/S0021-9258(18)66891-7","article-title":"Pantothenate-sodium cotransport in renal brush-border membranes","volume":"261","author":"Barbarat","year":"1986","journal-title":"J Biol Chem"},{"key":"B22-20230813","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1016\/0005-2736(84)90334-1","article-title":"Transport and metabolism of pantothenic acid by rat kidney","volume":"769","author":"Karnitz","year":"1984","journal-title":"Biochim Biophys Acta"},{"key":"B23-20230813","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.jpainsymman.2003.07.004","article-title":"Development of a symptom assessment instrument for chronic hemodialysis patients: The Dialysis Symptom Index","volume":"27","author":"Weisbord","year":"2004","journal-title":"J Pain Symptom Manage"},{"key":"B24-20230813","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1016\/S0735-1097(00)00531-3","article-title":"Development and evaluation of the Kansas City Cardiomyopathy Questionnaire: A new health status measure for heart failure","volume":"35","author":"Green","year":"2000","journal-title":"J Am Coll Cardiol"},{"key":"B25-20230813","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1161\/CIRCHEARTFAILURE.115.002097","article-title":"Kansas city cardiomyopathy questionnaire score is associated with incident heart failure hospitalization in patients with chronic kidney disease without previously diagnosed heart failure: Chronic renal insufficiency cohort study","volume":"8","author":"Mishra","year":"2015","journal-title":"Circ Heart Fail"},{"key":"B26-20230813","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.cardfail.2010.08.009","article-title":"Symptoms characteristic of heart failure among CKD patients without diagnosed heart failure","volume":"17","author":"Shlipak","year":"2011","journal-title":"J Card Fail"},{"key":"B27-20230813","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1161\/01.CIR.0000136991.85540.A9","article-title":"Prognostic value of health status in patients with heart failure after acute myocardial infarction","volume":"110","author":"Soto","year":"2004","journal-title":"Circulation"},{"key":"B28-20230813","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1161\/CIRCULATIONAHA.108.820472","article-title":"Patient health status and costs in heart failure: Insights from the eplerenone post-acute myocardial infarction heart failure efficacy and survival study (EPHESUS)","volume":"119","author":"Chan","year":"2009","journal-title":"Circulation"},{"key":"B29-20230813","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1016\/j.jacc.2005.11.021","article-title":"Health status identifies heart failure outpatients at risk for hospitalization or death","volume":"47","author":"Heidenreich","year":"2006","journal-title":"J Am Coll Cardiol"},{"issue":"Suppl 1","key":"B30-20230813","first-page":"S65","article-title":"II. NKF-K\/DOQI clinical practice guidelines for peritoneal dialysis adequacy: Update 2000","volume":"37","year":"2001","journal-title":"Am J Kidney Dis"},{"key":"B31-20230813","doi-asserted-by":"crossref","first-page":"85","DOI":"10.2215\/CJN.02570607","article-title":"Removal of the protein-bound solutes indican and p-cresol sulfate by peritoneal dialysis","volume":"3","author":"Pham","year":"2008","journal-title":"Clin J Am Soc Nephrol"},{"key":"B32-20230813","doi-asserted-by":"crossref","first-page":"2238","DOI":"10.1046\/j.1523-1755.2003.00310.x","article-title":"Removal of middle molecules and protein-bound solutes by peritoneal dialysis and relation with uremic symptoms","volume":"64","author":"Bammens","year":"2003","journal-title":"Kidney Int"},{"key":"B33-20230813","doi-asserted-by":"crossref","first-page":"290","DOI":"10.2215\/CJN.06100710","article-title":"Contribution of residual function to removal of protein-bound solutes in hemodialysis","volume":"6","author":"Marquez","year":"2011","journal-title":"Clin J Am Soc Nephrol"},{"issue":"Suppl 2","key":"B34-20230813","doi-asserted-by":"crossref","first-page":"S35","DOI":"10.1177\/089686089301302S09","article-title":"A three-pore model of peritoneal transport","volume":"13","author":"Rippe","year":"1993","journal-title":"Perit Dial Int"},{"key":"B35-20230813","doi-asserted-by":"crossref","first-page":"2147","DOI":"10.1093\/ndt\/gfn049","article-title":"Free water transport, small pore transport and the osmotic pressure gradient three-pore model of peritoneal transport","volume":"23","author":"Rippe","year":"2008","journal-title":"Nephrol Dial Transplant"},{"key":"B36-20230813","doi-asserted-by":"crossref","first-page":"3780","DOI":"10.1681\/ASN.2016010039","article-title":"Metabolic profiling of impaired cognitive function in patients receiving dialysis","volume":"27","author":"Kurella Tamura","year":"2016","journal-title":"J Am Soc Nephrol"}],"container-title":["Clinical Journal of the American Society of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2215\/CJN.11120919","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T13:39:40Z","timestamp":1786369180000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2215\/CJN.11120919"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,9]]},"references-count":36,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.2215\/cjn.11120919","relation":{},"ISSN":["1555-9041","1555-905X"],"issn-type":[{"value":"1555-9041","type":"print"},{"value":"1555-905X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3,9]]}}}