Bioimpedance Spectroscopy for the Detection of Fluid Overload in Chinese Peritoneal Dialysis Patients. Issue 4 (June 2014)

• Record Type: Journal Article
• Authors: Kwan, Bonnie Ching-Ha; Szeto, Cheuk-Chun; Chow, Kai-Ming; Law, Man-Ching; Cheng, Mei Shan; Leung, Chi-Bon; Pang, Wing-Fai; Kwong, Vickie Wai-Ki; Li, Philip Kam-Tao
• Is Part Of: Peritoneal dialysis international. Volume 34:Issue 4(2014)
• Page Start: 409
• Page End: 416
• Publication Date: 2014-06
• Subjects: Peritoneal dialysis -- fluid overload -- body composition monitor; Peritoneal dialysis -- Periodicals; Continuous ambulatory peritoneal dialysis -- Periodicals; 617.461059
• DOI: 10.3747/pdi.2013.00066
• Languages: English
• ISSNs: 0896-8608

Abstract

Background: Fluid overload probably contributes to the cardiovascular risk of peritoneal dialysis (PD) patients. We studied the relationship between over-hydration as determined by bioimpedance spectroscopy and dialysis adequacy, nutritional status, and arterial stiffness in Chinese PD patients. Methods: We studied 122 asymptomatic prevalent PD patients: bioimpedance spectroscopy, arterial pulse wave velocity, dialysis adequacy and nutritional status were determined. Results: Of the 122 patients, 88 (72.1%) had over-hydration of ≥ 1 L, while 25 (20.5%) were ≥ 5 L. Over-hydration significantly correlated with total body water (r = 0.474, p < 0.001) and extracellular water (r = 0.755, p < 0.001). Over-hydration was more severe in male and diabetic patients, and significantly correlated with Charlson's comorbidity score, blood pressure, body mass index, body weight, peritoneal transport characteristics, and carotid-femoral pulse wave velocity. Over-hydration significantly correlated with Kt/V (r = -0.287, p = 0.016), serum albumin level (r = -0.465, p < 0.001) and malnutrition inflammation score (r = 0.410, p = 0.006), but not residual renal function. Conclusion: Over-hydration is common in asymptomatic Chinese PD patients. The degree of over-hydration is particularly pronounced in patients who are inadequately dialyzed, have multiple comorbid conditions and low serum albumin levels. Over-hydration is associated with high blood pressure and arterial stiffness, and may contribute to the excessive risk of cardiovascular disease in this group of patients.