Skip to main content

Research Repository

Advanced Search

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.

Longitudinal bioimpedance vector plots add little value to fluid management of peritoneal dialysis patients Thumbnail


Authors

Boon K. Tan

Zanzhe Yu

Wei Fang

Aiwu Lin

Zhaohui Ni

Jiaqi Qian

Graham Woodrow

Sarah B. Jenkins

Martin E. Wilkie



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




You might also like



Downloadable Citations