Boon K. Tan
Longitudinal bioimpedance vector plots add little value to fluid management of peritoneal dialysis patients
Tan, Boon K.; Yu, Zanzhe; Fang, Wei; Lin, Aiwu; Ni, Zhaohui; Qian, Jiaqi; Woodrow, Graham; Jenkins, Sarah B.; Wilkie, Martin E.; Davies, Simon J.
Authors
Zanzhe Yu
Wei Fang
Aiwu Lin
Zhaohui Ni
Jiaqi Qian
Graham Woodrow
Sarah B. Jenkins
Martin E. Wilkie
Simon Davies s.j.davies@keele.ac.uk
Abstract
Bioimpedance (BI) has the potential to enable better management of fluid balance, which can worsen over time on peritoneal dialysis (PD) due to loss of residual kidney function and progressive muscle wasting. We undertook a prospective, randomized, open-label, blinded end-point controlled trial to determine whether availability of longitudinal BI measures as vector plots helped clinicians maintain stable fluid status over 12 months in 308 peritoneal dialysis patients from the United Kingdom and Shanghai, China. Patients were recruited into 4 groups nested within a single trial design according to country and residual kidney function. Nonanuric subjects from both countries demonstrated stable fluid volumes irrespective of randomization. Hydration worsened in control anuric patients in Shanghai with increased extracellular/total body water (ECW/TBW) ratio (0.04; 95% CI: 0.01, 0.06) and reduced TBW (-1.76?L 95% CI: -2.70, -0.82), but was stable in the BI intervention group whose dialysate glucose prescription was increased. However, multilevel analysis incorporating data from both countries showed worsening ECW/TBW in active and control anuric patients. Clinicians in the United Kingdom reduced target weight in the nonanuric BI intervention group causing a reduction in TBW without beneficial effects on ECW or blood pressure. Thus, routine use of longitudinal BI vector plots to improve clinical management of fluid status is not supported.Kidney International advance online publication, 14 October 2015; doi:10.1038/ki.2015.294.
Journal Article Type | Article |
---|---|
Acceptance Date | Aug 13, 2015 |
Online Publication Date | Jan 22, 2016 |
Publication Date | Jan 22, 2016 |
Publicly Available Date | Mar 28, 2024 |
Journal | Kidney International |
Print ISSN | 0085-2538 |
Publisher | Elsevier |
Peer Reviewed | Peer Reviewed |
Volume | 89 |
Issue | 2 |
DOI | https://doi.org/10.1038/ki.2015.294 |
Keywords | diuretics, peritoneal dialysis, peritoneal membrane, ultrafiltration,water and volume homeostasis |
Publisher URL | http://dx.doi.org/10.1038/ki.2015.294 |
Files
sd_ki_2016.pdf
(1.2 Mb)
PDF
Publisher Licence URL
https://creativecommons.org/licenses/by-nc-sa/4.0/
You might also like
An update on absolute and relative indications for dialysis treatment modalities
(2023)
Journal Article
Salt and Water Balance
(2022)
Book Chapter
Downloadable Citations
About Keele Repository
Administrator e-mail: research.openaccess@keele.ac.uk
This application uses the following open-source libraries:
SheetJS Community Edition
Apache License Version 2.0 (http://www.apache.org/licenses/)
PDF.js
Apache License Version 2.0 (http://www.apache.org/licenses/)
Font Awesome
SIL OFL 1.1 (http://scripts.sil.org/OFL)
MIT License (http://opensource.org/licenses/mit-license.html)
CC BY 3.0 ( http://creativecommons.org/licenses/by/3.0/)
Powered by Worktribe © 2024
Advanced Search