Journal Article

The Effect of Strict Volume Control Assessed by Repeated Bioimpedance Spectroscopy on Cardiac Function in Peritoneal Dialysis Patients

Hong, Yu Ah, Shin, Sug Kyun, Yoon, Hye Eun, Kim, Yong-Soo, Chang, Yoon Kyung, Choi, Bum Soon, Shin, Seok Joon, Lee, Eun Young, Lee, Sang-Ho, Ko, Gang Jee, Lee, So Young, Kwon, Young Joo, Ahn, Shin Young, Kim, Ji Eun, Kim, Su Hyun, Kim, Jeong Ho, Kim, Suk Young

2019

Overview

Adequate fluid management plays an important role in decreasing cardiovascular risk in peritoneal dialysis (PD) patients. We evaluated whether strict volume control monitored by bioimpedance spectroscopy (BIS) affects cardiac function in PD patients. This study is a secondary analysis of a multicentre, prospective, randomized, controlled trial. Fluid overload was assessed by the average overhydration/extracellular water (OH/ECW) at baseline, 6 months and 12 months. Patients were categorized as time-averaged overhydrated (TA-OH/ECW ≥15%) or normohydrated (TA-OH/ECW <15%), and echocardiographic parameters were compared between groups. Among a total of 151 patients, 120 patients exhibited time-averaged normohydration. Time-averaged overhydrated patients had a significantly higher left atrial (LA) diameter and E/e′ ratio and a lower left ventricular (LV) ejection fraction at 12 months than time-averaged normohydrated patients. LA diameter, end-systolic volume and end-diastolic volume were decreased at 12 months compared to baseline in time-averaged normohydrated patients only. TA-OH/ECW was independently associated with ejection fraction at 12 months (β = −0.190; p = 0.010). TA-OH/ECW, but not OH/ECW at 12 months, was an independent risk factor for LV dysfunction (odds ratio 4.020 [95% confidence interval 1.285–12.573]). Overhydration status based on repeated BIS measurements is an independent predictor of LV systolic function in PD patients.

• Publisher: Nature Publishing Group UK,Nature Publishing Group
• Subject: 692/308/409 / 692/4022/1950/1724 / 9/10 / Adult / Aged / Cardiac function / Cardiovascular diseases / Cardiovascular Diseases - etiology / Dialysis / Dielectric Spectroscopy - methods / Female / Health risks / Heart / Heart Function Tests - methods / Humanities and Social Sciences / Humans / Kidney Failure, Chronic - therapy / Male / Middle Aged / multidisciplinary / Organism Hydration Status / Peritoneal dialysis / Peritoneal Dialysis - adverse effects / Peritoneum / Prospective Studies / Risk factors / Science / Science (multidisciplinary) / Secondary analysis / Spectroscopy / Spectrum analysis / Stroke Volume / Ventricle / Ventricular Function, Left / Water-Electrolyte Imbalance