Document Detail


Symptomatic fluid retention in patients on continuous peritoneal dialysis.
MedLine Citation:
PMID:  7579085     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The clinical features, pathogenesis, management, prognosis, and predictors of symptomatic fluid gain (SFR) were analyzed for 71 episodes occurring in 66 patients on continuous peritoneal dialysis, 94.4% on continuous ambulatory peritoneal dialysis (CAPD) and 5.6% on continuous cycling peritoneal dialysis. Compared with a control group of 149 CAPD patients, the SFR group had a higher percentage of diabetics (64 versus 46%) and a higher frequency of noncompliance with fluid restriction (76 versus 22%), salt restriction (74 versus 23%), and performance of dialysis (30 versus 7%) (all at P < or = 0.015). Peripheral edema (100%), pulmonary congestion (80%), pleural effusions (76%), and systolic (83%) and diastolic (66%) hypertension were the most common manifestations of SFR. The annual hospitalization rate for SFR was 4.1 +/- 5.8 days per patient. SFR resulted in the discontinuation of CAPD in 10 patients and death in 1 patient. Serum sodium concentration was not different between dry and maximal weight in the SFR group. Thirty-eight (58%) of SFR and 61 (41%) of control patients were evaluated by peritoneal equilibration tests (PET). SFR patients had lower PET drain volume (2.08 +/- 0.47 versus 2.54 +/- 0.23 L) and a higher frequency of high peritoneal solute transport (32.2 versus 2.4%). In this group, logistic regression identified dietary noncompliance, low PET drain volume, and young age as independent predictors of SFR. Response to management and preventive measures was inconsistent. The best results were obtained by the use of short dwell exchanges with hypertonic dialysate in compliant patients with high peritoneal solute transport. SFR has serious consequences in CAPD. (ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
A H Tzamaloukas; M C Saddler; G H Murata; D Malhotra; P Sena; D Simon; K L Hawkins; K Morgan; M Nevarez; B Wood
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American Society of Nephrology : JASN     Volume:  6     ISSN:  1046-6673     ISO Abbreviation:  J. Am. Soc. Nephrol.     Publication Date:  1995 Aug 
Date Detail:
Created Date:  1995-12-22     Completed Date:  1995-12-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9013836     Medline TA:  J Am Soc Nephrol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  198-206     Citation Subset:  IM    
Affiliation:
Albuquerque Veterans Affairs Medical Center, NM 87108, USA.
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MeSH Terms
Descriptor/Qualifier:
Diet, Sodium-Restricted
Edema / diagnosis,  etiology*,  therapy
Female
Humans
Logistic Models
Male
Middle Aged
Peritoneal Dialysis
Peritoneal Dialysis, Continuous Ambulatory* / statistics & numerical data
Pleural Effusion / diagnosis,  etiology,  therapy
Retrospective Studies
Treatment Refusal

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


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