scholarly journals Assessment of Volume Status in Peritoneal Dialysis Patients

10.5772/64023 ◽  
2016 ◽  
Author(s):  
Olga Balafa
Keyword(s):  
Peritoneal Dialysis ◽  
Volume Status ◽  
Dialysis Patients

Volume Status and Blood Pressure in Continuous Ambulatory Peritoneal Dialysis Patients

2005 ◽  
Vol 23 (5) ◽  
pp. 373-378 ◽  
Author(s):  
Xin Wang ◽  
Jonas Axelsson ◽  
Bengt Lindholm ◽  
Tao Wang
Keyword(s):  
Blood Pressure ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Volume Status ◽  
Dialysis Patients

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 Inflammation is associated to volume status in peritoneal dialysis patients

Renal Failure ◽  
2015 ◽  
Vol 37 (6) ◽  
pp. 935-940 ◽  
Author(s):  
Aydin Unal ◽  
Feridun Kavuncuoglu ◽  
Mustafa Duran ◽  
Fatih Oguz ◽  
Ismail Kocyigit ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Volume Status ◽  
Dialysis Patients

Volume Overhydration is Related to Endothelial Dysfunction in Continuous Ambulatory Peritoneal Dialysis Patients

2008 ◽  
Vol 28 (4) ◽  
pp. 397-402 ◽  
Author(s):  
Li-Tao Cheng ◽  
Yan-Li Gao ◽  
Chao Qin ◽  
Jun-Ping Tian ◽  
Yue Gu ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Endothelial Dysfunction ◽  
Endothelial Function ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Cardiovascular Morbidity ◽  
Morbidity And Mortality ◽  
Volume Status ◽  
Dialysis Patients ◽  
Cardiovascular Morbidity And Mortality ◽  
Dialysis Vintage

Objective In dialysis patients, volume overhydration is common and is related to increased risk of cardiovascular morbidity and mortality. However, it remains unclear whether volume overload imposes those detrimental effects through endothelial dysfunction. Methods In this cross-sectional study, 81 stable patients on continuous ambulatory peritoneal dialysis in a single center were recruited. Volume status was evaluated by extracellular water, assessed by bioimpedance analysis, and normalized to individual height (nECW). Endothelial function was estimated by endothelial-dependent flow-mediated dilatation (FMD) of the brachial artery and expressed as percentage change relative to baseline diameter. Results There were 37 male and 44 female patients (mean age 61 ± 12 years, dialysis vintage 20 ± 23 months). FMD in female patients was significantly higher than that in male patients (9.17% ± 6.23% vs 6.31% ± 5.01%, p < 0.05). FMD was negatively correlated with weight ( r = -0.308, p < 0.01), body mass index ( r = -0.242, p < 0.05), systolic blood pressure ( r = -0.228, p < 0.05), ECW ( r = -0.404, p < 0.001), and nECW ( r = -0.418, p < 0.001). No correlation was found between FMD and other variables. In multiple stepwise regression analysis, calcium x phosphate product (² = 0.422, p < 0.001), nECW (² = -0.343, p < 0.01), and dialysis vintage (² = -0.237, p < 0.05) were independent determinants of FMD (adjusted R2 = 0.327 for this model). Conclusion There was independent correlation between index of volume status and FMD, and higher nECW was related to worse endothelial function. The results of this study may help us understand the underlying mechanism of volume overhydration leading to increased cardiovascular morbidity and mortality in dialysis patients.

Body Composition, Hydration, and Related Parameters in Hemodialysis versus Peritoneal Dialysis Patients

2010 ◽  
Vol 30 (2) ◽  
pp. 208-214 ◽  
Author(s):  
Isabel Devolder ◽  
Annick Verleysen ◽  
Denise Vijt ◽  
Raymond Vanholder ◽  
Wim Van Biesen
Keyword(s):  
Body Composition ◽  
Peritoneal Dialysis ◽  
Volume Overload ◽  
Volume Status ◽  
Extracellular Water ◽  
Multivariate Models ◽  
Dialysis Patients ◽  
Multifrequency Bioimpedance ◽  
Total Body ◽  
Composition Monitoring

AimsMaintaining euvolemia is an important goalin patients on renal replacement therapy. However, adequate assessment of volume status in clinical practice is hampered by a lack of accurate measuring tools. A new multifrequency bioimpedance tool has recently been validated. This study compares volume status in peritoneal dialysis (PD) and hemodialysis (HD) patients in a single center.MethodsBody Composition Monitoring (BCM; Fresenius Medical Care, Bad Homburg, Germany) was performed in all patients on PD or HD without contraindication. PD patients were measured with a full abdomen; HD patients were measured at the midweek session, once immediately before and once 20 minutes after dialysis. Clinical overhydration was defined as an overhydration-to-extracellular water ratio of >0.15.ResultsTotal body water, extracellular water, and intracellular water were 33.7 ± 6.9 L versus 31.8 ± 8.1 L vs 33.9 ± 6.7 L, 16.4 ± 3.9 L vs 15.3 ± 4.9 L vs 16.8 ± 3.3 L, and 17.1 ± 6.2 L vs 16.5 ± 4.6 L vs 17.2 ± 3.9 L in the pre-HD, post-HD, and PD patients, respectively ( p = NS). In the pre-HD and the PD patients, overhydration was 1.9 ± 1.7 L and 2.1 ± 2.3 L, whereas post-HD this was only 0.6 ± 1.7 L ( p < 0.001). Clinical overhydration was more prevalent in pre-HD and PD patients compared to post-HD patients (24.1% vs 22.3% vs 10%, p < 0.001). In multivariate models, overhydration was related to age, male gender, and post-HD status.ConclusionAlthough much clinical attention is paid to volume status, 24% of patients still have clinically relevant volume overload. Implementation of a reliable and clinically applicable tool to assess volume status is therefore necessary. It is possible to obtain comparable volume status in PD and HD patients.

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