eprintid: 1561101
rev_number: 36
eprint_status: archive
userid: 608
dir: disk0/01/56/11/01
datestamp: 2017-07-02 03:17:21
lastmod: 2021-11-01 02:29:27
status_changed: 2017-08-22 11:39:50
type: article
metadata_visibility: show
creators_name: Udo, A
creators_name: Goodlad, C
creators_name: Davenport, A
title: Impact of Diabetes on Extracellular Volume Status in Patients Initiating Peritoneal Dialysis
ispublished: pub
divisions: UCL
divisions: B02
divisions: C10
divisions: D17
keywords: Science & Technology, Life Sciences & Biomedicine, Urology & Nephrology, Bioimpedance, Peritoneal dialysis, Muscle mass, Fat mass, Extracellular water, Intracellular water, Albumin, RENAL REPLACEMENT THERAPY, FLUID STATUS, MULTIFREQUENCY BIOIMPEDANCE, CONTROLLED-TRIAL, MELLITUS, ASSOCIATION, SURVIVAL, ALBUMIN, SODIUM
note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
abstract: 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 β 0.24, p < 0.001), N terminal brain natriuretic peptide (β 0.24, p < 0.001), ECW/TBW (β 0.19, p = 0.012) and negatively with serum albumin (β -0.14, p = 0.033) and creatinine (β -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.
date: 2017-06-01
date_type: published
publisher: KARGER
official_url: http://doi.org/10.1159/000477326
oa_status: green
full_text_type: other
language: eng
primo: open
primo_central: open_green
article_type_text: Article
verified: verified_manual
elements_id: 1299356
doi: 10.1159/000477326
lyricists_name: Davenport, Andrew
lyricists_id: ADAVE78
full_text_status: public
publication: American Journal of Nephrology
volume: 46
number: 1
pagerange: 18-25
pages: 8
issn: 1421-9670
citation:        Udo, A;    Goodlad, C;    Davenport, A;      (2017)    Impact of Diabetes on Extracellular Volume Status in Patients Initiating Peritoneal Dialysis.                   American Journal of Nephrology , 46  (1)   pp. 18-25.    10.1159/000477326 <https://doi.org/10.1159/000477326>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/1561101/1/Davenport-A_impact%20of%20diabetes%20on%20extracelluar_.pdf