Relationship between sodium removal, hydration and outcomes in peritoneal dialysis patients

Nephrology ◽  
2021 ◽  
Author(s):  
Natalie M.‐Y. Mok ◽  
Nicholas Fan ◽  
Hazel Finney ◽  
Stanley L.‐S. Fan
Keyword(s):  
Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Sodium Removal

scholarly journals Influence of Different Payment Schemes on the Clinical Outcome in Peritoneal Dialysis Patients

2015 ◽  
Vol 36 (2) ◽  
pp. 205-212
Author(s):  
Chun-yan Su ◽  
Xin-hong Lu ◽  
Tao Wang
Keyword(s):  
Peritoneal Dialysis ◽  
Clinical Outcome ◽  
Dietary Intake ◽  
Nutrition Status ◽  
Volume Status ◽  
Dialysis Patients ◽  
Dialysis Adequacy ◽  
Sodium Removal ◽  
Significant Difference ◽  
Payment Schemes

Background Cost is always a big issue for dialysis patients. In the present study, we analyzed the effect of different payment schemes on dialysis adequacy and clinical outcome in our peritoneal dialysis program. Methods This is a single-center cohort study. A total of 175 patients who began dialysis from January 2006 to December 2007 were included. Baseline data, including volume status, dietary intake and nutrition status, dialysis adequacy, and sodium removal were collected at 6 months after peritoneal dialysis. Based on the different payment schemes, the patients were divided into 2 groups, higher payment group (GHP, 130 cases, with more than 85% reimbursement), and lower payment group (GLP, 45 cases, with less than 50% payment or totally self-paid). Patients were followed up until dropout or until December 31, 2013. Results At baseline, patients in the 2 groups had nearly the same residual renal function. But the GLP group patients dialyzed at a lower dose (4,516.91 ± 1,768.20 mL vs 6,058.17 ± 2,013.43 mL, p < 0.001). They had lower creatinine clearance (51.64 ± 24.23 L/w vs 70.54 ± 30.27 L/w, p < 0.001), sodium removal (2.23 ± 1.29 g vs 2.77 ± 1.29 g, p = 0.027), and fluid removal (970.33 ± 545.97 mL vs 1,146.66 ± 460.93 mL, p = 0.038). Normalized by height (in meters), the GLP group patients still had a lower normalized dialysis dose (2,890.61 ± 1084.44 mL/m vs 3,761.34 ± 1,237.10 mL/m, p < 0.001). Baseline nutritional and dietary parameters were comparable except that a lower daily protein intake (42.73 ± 10.99 g vs 47.26 ± 14.30 g, p = 0.032) and higher serum urea level (23.43 ± 6.88 mmol/L vs 19.84 ± 5.92 mmol/L, p < 0.001) were presented in the GLP group. There was no difference in volume status. During the follow-up, Kaplan-Meier analysis showed that there was no significant difference in patient survival and technique survival. In multivariate Cox regression analysis, after adjusting for related factors, payment was again not a strong predictor of survival in the study population. Conclusion Our study found that GLP group patients were adherent to lifestyle modification with lower dialysis doses, and they also had nearly the same long-term clinical outcome as the GHP group patients. Thus, lower dialysis doses combined with controlled dietary intake may be an effective approach to solve the dialysis problem for the low socio-economic status (SES) population.

scholarly journals Comparison of sodium removal in peritoneal dialysis patients treated by continuous ambulatory and automated peritoneal dialysis

2019 ◽  
Vol 32 (6) ◽  
pp. 1011-1019 ◽  
Author(s):  
Sarju Raj Singh Maharjan ◽  
Andrew Davenport
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Fluid Balance ◽  
Automated Peritoneal Dialysis ◽  
Peritoneal Membrane ◽  
Dialysis Patients ◽  
Membrane Function ◽  
Peritoneal Dialysate ◽  
Hypertonic Glucose ◽  
Sodium Removal

Abstract Background Optimal fluid balance for peritoneal dialysis (PD) patients requires both water and sodium removal. Previous studies have variously reported that continuous ambulatory peritoneal dialysis (CAPD) removes more or equivalent amounts of sodium than automated PD (APD) cyclers. We therefore wished to determine peritoneal dialysate losses with different PD treatments. Methods Peritoneal and urinary sodium losses were measured in 24-h collections of urine and PD effluent in patients attending for their first assessment of peritoneal membrane function. We adjusted fluid and sodium losses for CAPD patients for the flush before fill technique. Results We reviewed the results from 659 patients, mean age 57 ± 16 years, 56.3% male, 38.9% diabetic, 24.0% treated by CAPD, 22.5% by APD and 53.5% APD with a day-time exchange, with icodextrin prescribed to 72.8% and 22.7 g/L glucose to 31.7%. Ultrafiltration was greatest for CAPD 650 (300–1100) vs 337 (103–598) APD p < 0.001, vs 474 (171–830) mL/day for APD with a day exchange. CAPD removed most sodium 79 (33–132) vs 23 (− 2 to 51) APD p < 0.001, and 51 (9–91) for APD with a day exchange, and after adjustment for the CAPD flush before fill 57 (20–113), p < 0.001 vs APD. APD patients with a day exchanged used more hypertonic glucose dialysates [0 (0–5) vs CAPD 0 (0–1) L], p < 0.001. Conclusion CAPD provides greater ultrafiltration and sodium removal than APD cyclers, even after adjusting for the flush-before fill, despite greater hypertonic usage by APD cyclers. Ultrafiltration volume and sodium removal were similar between CAPD and APD with a day fill.

scholarly journals Clinical Factors Associated with Sodium Removal in Peritoneal Dialysis Patients

2011 ◽  
Vol 39 (5) ◽  
pp. 1883-1889 ◽  
Author(s):  
YS Shan ◽  
XQ Ding ◽  
J Ji ◽  
WL Lv ◽  
XS Cao ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Clinical Factors ◽  
Dialysis Patients ◽  
Factors Associated ◽  
Sodium Removal

Compared time profiles of ultrafiltration, sodium removal, and renal function in incident CAPD and automated peritoneal dialysis patients

2004 ◽  
Vol 44 (1) ◽  
pp. 132-145 ◽  
Author(s):  
Ana Rodrıéguez-Carmona ◽  
Miguel Pérez-Fontán ◽  
Rafael Garcıéa-Naveiro ◽  
Pedro Villaverde ◽  
Javier Peteiro
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Automated Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Time Profiles ◽  
Sodium Removal

THE EFFECT OF FLUID AND SODIUM REMOVAL ON BLOOD PRESSURE IN PERITONEAL DIALYSIS PATIENTS

2000 ◽  
Vol 18 ◽  
pp. S99-S100
Author(s):  
G. Nergizoglu ◽  
K. Ates ◽  
S. Erturk ◽  
K. Keven ◽  
O. Karatan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Sodium Removal

scholarly journals Effect of fluid and sodium removal on mortality in peritoneal dialysis patients

2001 ◽  
Vol 60 (2) ◽  
pp. 767-776 ◽  
Author(s):  
Kenan Ateş ◽  
Gökhan Nergızoğlu ◽  
Kenan Keven ◽  
Arzu Şen ◽  
Sim Kutlay ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Sodium Removal

Combination of Crystalloid (Glucose) and Colloid (Icodextrin) Osmotic Agents Markedly Enhances Peritoneal Fluid and Solute Transport during the Long PD Dwell

2007 ◽  
Vol 27 (3) ◽  
pp. 267-276 ◽  
Author(s):  
Philippe Freida ◽  
Magda Galach ◽  
Jose C. Divino Filho ◽  
Andrzej Werynski ◽  
Bengt Lindholm
Keyword(s):  
Peritoneal Dialysis ◽  
Solute Transport ◽  
Residual Renal Function ◽  
Transport Rate ◽  
Dialysis Patients ◽  
Fluid Removal ◽  
Sodium Removal ◽  
Ultra Filtration ◽  
Osmotic Agents ◽  
Peritoneal Solute Transport Rate

Background Fluid and sodium removal is often inadequate in peritoneal dialysis patients with high peritoneal solute transport rate, especially when residual renal function is declining. Method We studied the effects of using simultaneous crystalloid (glucose) and colloid (icodextrin) osmotic agents on the peritoneal transport of fluid, sodium, and other solutes during 15-hour single-dwell exchanges using 3.86% glucose, 7.5% icodextrin, and a combination fluid with 2.61% glucose and 6.8% icodextrin in 7 prevalent peritoneal dialysis patients with fast peritoneal solute transport rate. Results The combination fluid enhanced net ultrafiltration (mean 990 mL) and sodium removal (mean 158 mmol) compared with 7.5% icodextrin (mean net ultrafiltration 462 mL, mean net sodium removal 49 mmol). In contrast, the 3.86% glucose-based solution yielded negligible ultra-filtration (mean -85 mL) and sodium removal (mean 16 mmol). The combination solution resulted in significantly improved urea (+41%) and creatinine (+26%) clearances compared with 7.5% icodextrin. Conclusion A solution containing both crystalloid (glucose 2.61%) and colloid (icodextrin 6.8%) osmotic agents enhanced fluid removal by twofold and sodium removal by threefold compared with 7.5% icodextrin solution during a dwell of 15 hours, indicating that such a combination solution could represent a new treatment option for anuric peritoneal dialysis patients with high peritoneal solute transport rate.

Which Method Should Be Used to Assess Protein Intake in Peritoneal Dialysis Patients? Assessment of Agreement Between Protein Equivalent of Total Nitrogen Appearance and 24-Hour Dietary Recall

2020 ◽  
Author(s):  
Maryanne Zilli Canedo Silva ◽  
Barbara Perez Vogt ◽  
Nayrana Soares Carmo Reis ◽  
Rogerio Carvalho Oliveira ◽  
Jacqueline Costa Teixeira Caramori
Keyword(s):  
Peritoneal Dialysis ◽  
Total Nitrogen ◽  
Protein Intake ◽  
Dialysis Patients ◽  
Dietary Recall
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