TY  - JOUR
IS  - 1
N1  - This version is the author accepted manuscript. For information on re-use, please refer to the publisher?s terms and conditions.
VL  - 46
SP  - 18
JF  - American Journal of Nephrology
A1  - Udo, A
A1  - Goodlad, C
A1  - Davenport, A
UR  - http://doi.org/10.1159/000477326
SN  - 1421-9670
TI  - Impact of Diabetes on Extracellular Volume Status in Patients Initiating Peritoneal Dialysis
AV  - public
Y1  - 2017/06/01/
EP  - 25
KW  - Science & Technology
KW  -  Life Sciences & Biomedicine
KW  -  Urology & Nephrology
KW  -  Bioimpedance
KW  -  Peritoneal dialysis
KW  -  Muscle mass
KW  -  Fat mass
KW  -  Extracellular water
KW  -  Intracellular water
KW  -  Albumin
KW  -  RENAL REPLACEMENT THERAPY
KW  -  FLUID STATUS
KW  -  MULTIFREQUENCY BIOIMPEDANCE
KW  -  CONTROLLED-TRIAL
KW  -  MELLITUS
KW  -  ASSOCIATION
KW  -  SURVIVAL
KW  -  ALBUMIN
KW  -  SODIUM
N2  - Background: Recent reports have highlighted that diabetic patients with kidney failure are at increased risk of technique failure and transfer to haemodialysis within 90 days of initiating peritoneal dialysis (PD). We wished to determine whether there were differences between diabetic and non-diabetic patients within the first 3 months of starting PD. Methods: We reviewed results of corresponding bioimpedance and the 1st test of peritoneal membrane function (PET) in consecutive patients, 6-10 weeks after initiating PD electively. Results: Adult patients numbering 386 - 230 males (59.6%), 152 (39.4%) diabetic, 188 (48.7%) white, mean age 57.3 ±16.9 years - were studied. Although weight, residual renal function and peritoneal clearances were not different, diabetic patients had greater extracellular water to total body water (ECW/TBW; 40.4 ± 1.1 vs. 39.2 ± 1.4) and % ECW excess (9.6 [6.3-12.3] vs. 4.9 [0.7-8.9]), lower serum albumin (35.2 ± 4.7 vs. 37.8 ± 4.9 g/L), greater fat mass index (9.5 ± 4.2 vs. 7.7 ± 4.2), and although mean arterial blood pressure was similar, arterial pulse pressure was greater (66.9 ± 10.8 vs. 54.3 ± 17.3 mm Hg, all p < 0.001). On multivariate analysis, glycated haemoglobin was associated with pulse pressure (standardised ? 0.24, p < 0.001), N terminal brain natriuretic peptide (? 0.24, p < 0.001), ECW/TBW (? 0.19, p = 0.012) and negatively with serum albumin (? -0.14, p = 0.033) and creatinine (? -0.18, p = 0.02). Conclusion: Diabetic patients electively starting PD were found to have greater ECW/TBW ratios and ECW excess 6-10 weeks after starting PD compared to non-diabetics, despite similar PET. Increased ECW could predispose diabetic patients to be at greater risk of volume overload.
ID  - discovery1561101
PB  - KARGER
ER  -