Document Detail


Comparison of fluid status in patients treated by different modalities of peritoneal dialysis using multi-frequency bioimpedance.
MedLine Citation:
PMID:  20020409     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIMS: Patients treated by peritoneal dialysis, especially those using automatic cyclers, are frequently found to be hypervolemic. To determine whether there are significant differences between the currently available modalities of peritoneal dialysis, we analyzed whether differences in transporter status and treatment modality had a discernible effect on extracellular fluid volumes as measured by multi-frequency bioimpedance. METHODS: Two hundred prevalent peritoneal dialysis patients, 48% male, mean age 54.9 yr (SD+/-15.6), were studied using multi-frequency bioimpedance following a standard peritoneal equilibration test; 63 patients were treated by CAPD, 29 by APD, 96 by CCPD and 12 by OCCPD. RESULTS: There were no differences in extracellular volumes, or extracellular volume adjusted for height, or as a ratio to total body water between the groups. As expected, extracellular volume adjusted for height depended upon bodyweight (r=0.412, p<0.001), sex (r=0.457, p<0.001) and systolic blood pressure (r=0.162, p=0.023), and extracellular volume to total body water related to the reciprocal of total daily peritoneal ultrafiltration losses (r=-0.0254, p=0.003) and urine output (-0.254, p=0.003). More importantly, on logistical regression analysis the ratio of extracellular fluid to total body fluid increased with falling albumin, F=21.5 p<0.001, increasing age, F=18.5 p<0.001, urine output F=6.46, p=0.014, total daily ultrafiltration, F=3.52 and protein intake p=0.003. Extracellular fluid adjusted for total body fluid was associated with CRP (males F=6.03, p=0.03, females F=4.438, p=0.04). CONCLUSION: Patients were more likely to have an expanded extracellular fluid volume if they had reduced daily fluid losses, but also with biomarkers typically associated with poor nutrition and inflammation.
Authors:
Andrew Davenport; Michelle Willicombe
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The International journal of artificial organs     Volume:  32     ISSN:  0391-3988     ISO Abbreviation:  Int J Artif Organs     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-12-18     Completed Date:  2010-02-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802649     Medline TA:  Int J Artif Organs     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  779-86     Citation Subset:  IM    
Affiliation:
University College London Center for Nephrology, University College Medical School, London - UK. Andrew.davenport@royalfree.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Blood Pressure
Body Composition*
Body Height
Body Weight
Electric Impedance*
Female
Humans
Inflammation Mediators / metabolism
Logistic Models
Male
Middle Aged
Nutritional Status
Peritoneal Dialysis / adverse effects,  methods*
Risk Factors
Sex Factors
Urination
Water-Electrolyte Balance*
Water-Electrolyte Imbalance / etiology*,  physiopathology
Chemical
Reg. No./Substance:
0/Inflammation Mediators

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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