Panorchan, K;
Davenport, A;
(2017)
Increase in Extracellular Hydration Status After Initiating Peritoneal Dialysis Electively.
Peritoneal Dialysis International
, 37
(3)
pp. 338-340.
10.3747/pdi.2016.00213.
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Abstract
Renal replacement therapy is designed to treat uremic symptoms and correct hypervolemia. We hypothesized that starting peritoneal dialysis (PD) should reduce overhydration, and we measured body composition and hydration status using bioimpedance in PD patients prior to training and then at the first assessment of peritoneal membrane function. We studied 100 consecutive patients with a planned start to PD, without peritoneal infections or mechanical catheter problems, mean age 54.7 ± 17.1 years, 57% male and 25% diabetic. Extracellular water (ECW) overhydration increased from -0.06 (-1.21 to 0.97) L to 0.96 (0.50 to 3.01) L, p < 0.001. Fat mass increased from 22.7 ± 11.1 to 23.7 ± 11.3 kg, p = 0.007). The change in ECW/total body water (TBW) was associated with age (β 0.065, p < 0.001), increasing comorbidity (β 1.107, p = 0.005), faster peritoneal protein transport (β 1.84, p < 0.04), and negatively with serum albumin (β -0.208, p < 0.001), and residual renal function (β -0.725, p = 0.026). Patients who had an increase in ECW/TBW had higher C-reactive protein (CRP) both before starting (16.8 ± 24.1 vs 7.7 ± 18.9 mg/L), and when established on PD (15.0 ± 31.8 vs 4.6 ± 5.1 mg/L), p < 0.05. Rather than a reduction in ECW hydration status, overhydration increased after starting PD. This was greater for older more comorbid patients and those with an inflammatory milieu and lower residual renal function. These factors should be considered when deciding upon initial PD prescriptions to limit ECW overhydration before information on peritoneal membrane function becomes available.
| Type: | Article |
|---|---|
| Title: | Increase in Extracellular Hydration Status After Initiating Peritoneal Dialysis Electively |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3747/pdi.2016.00213 |
| Publisher version: | https://doi.org/10.3747/pdi.2016.00213 |
| Language: | English |
| Additional information: | This version is the version of record. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Bioelectrical impedance, peritoneal dialysis, glucose, icodextrin, extracellular water, intracellular water |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10059446 |
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