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Fluid status in peritoneal dialysis patients: the European Body Composition Monitoring (EuroBCM) study cohort

Wim Van Biesen UGent, John D Williams, Adrian C Covic, Stanley Fan, Kathleen Claes, Monika Lichodziejewska-Niemierko, Christian Verger, Jurg Steiger, Volker Schoder, Peter Wabel, et al. (2011) PLOS ONE. 6(2).
abstract
Background: Euvolemia is an important adequacy parameter in peritoneal dialysis (PD) patients. However, accurate tools to evaluate volume status in clinical practice and data on volume status in PD patients as compared to healthy population, and the associated factors, have not been available so far. Methods: We used a bio-impedance spectroscopy device, the Body Composition Monitor (BCM) to assess volume status in a cross-sectional cohort of prevalent PD patients in different European countries. The results were compared to an age and gender matched healthy population. Results: Only 40% out of 639 patients from 28 centres in 6 countries were normovolemic. Severe fluid overload was present in 25.2%. There was a wide scatter in the relation between blood pressure and volume status. In a multivariate analysis in the subgroup of patients from countries with unrestricted availability of all PD modalities and fluid types, older age, male gender, lower serum albumin, lower BMI, diabetes, higher systolic blood pressure, and use of at least one exchange per day with the highest hypertonic glucose were associated with higher relative tissue hydration. Neither urinary output nor ultrafiltration, PD fluid type or PD modality were retained in the model (total R 2 of the model = 0.57). Conclusions: The EuroBCM study demonstrates some interesting issues regarding volume status in PD. As in HD patients, hypervolemia is a frequent condition in PD patients and blood pressure can be a misleading clinical tool to evaluate volume status. To monitor fluid balance, not only fluid output but also dietary input should be considered. Close monitoring of volume status, a correct dialysis prescription adapted to the needs of the patient and dietary measures seem to be warranted to avoid hypervolemia.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
RESIDUAL RENAL-FUNCTION, BIOIMPEDANCE SPECTROSCOPY, CHRONIC KIDNEY-DISEASE, HEMODIALYSIS-PATIENTS, ANURIC PATIENTS, BLOOD-PRESSURE, CAPD PATIENTS, VOLUME, MANAGEMENT, SURVIVAL
journal title
PLOS ONE
PLoS One
volume
6
issue
2
article number
e17148
pages
9 pages
Web of Science type
Article
Web of Science id
000287761700032
JCR category
BIOLOGY
JCR impact factor
4.092 (2011)
JCR rank
12/84 (2011)
JCR quartile
1 (2011)
ISSN
1932-6203
DOI
10.1371/journal.pone.0017148
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1269124
handle
http://hdl.handle.net/1854/LU-1269124
date created
2011-06-20 15:21:49
date last changed
2016-12-21 15:42:20
@article{1269124,
  abstract     = {Background: Euvolemia is an important adequacy parameter in peritoneal dialysis (PD) patients. However, accurate tools to evaluate volume status in clinical practice and data on volume status in PD patients as compared to healthy population, and the associated factors, have not been available so far. Methods: We used a bio-impedance spectroscopy device, the Body Composition Monitor (BCM) to assess volume status in a cross-sectional cohort of prevalent PD patients in different European countries. The results were compared to an age and gender matched healthy population. Results: Only 40\% out of 639 patients from 28 centres in 6 countries were normovolemic. Severe fluid overload was present in 25.2\%. There was a wide scatter in the relation between blood pressure and volume status. In a multivariate analysis in the subgroup of patients from countries with unrestricted availability of all PD modalities and fluid types, older age, male gender, lower serum albumin, lower BMI, diabetes, higher systolic blood pressure, and use of at least one exchange per day with the highest hypertonic glucose were associated with higher relative tissue hydration. Neither urinary output nor ultrafiltration, PD fluid type or PD modality were retained in the model (total R 2 of the model = 0.57). Conclusions: The EuroBCM study demonstrates some interesting issues regarding volume status in PD. As in HD patients, hypervolemia is a frequent condition in PD patients and blood pressure can be a misleading clinical tool to evaluate volume status. To monitor fluid balance, not only fluid output but also dietary input should be considered. Close monitoring of volume status, a correct dialysis prescription adapted to the needs of the patient and dietary measures seem to be warranted to avoid hypervolemia.},
  articleno    = {e17148},
  author       = {Van Biesen, Wim and Williams, John D and Covic, Adrian C and Fan, Stanley and Claes, Kathleen and Lichodziejewska-Niemierko, Monika and Verger, Christian and Steiger, Jurg and Schoder, Volker and Wabel, Peter and Gauly, Adelheid and Himmele, Rainer},
  issn         = {1932-6203},
  journal      = {PLOS ONE},
  keyword      = {RESIDUAL RENAL-FUNCTION,BIOIMPEDANCE SPECTROSCOPY,CHRONIC KIDNEY-DISEASE,HEMODIALYSIS-PATIENTS,ANURIC PATIENTS,BLOOD-PRESSURE,CAPD PATIENTS,VOLUME,MANAGEMENT,SURVIVAL},
  language     = {eng},
  number       = {2},
  pages        = {9},
  title        = {Fluid status in peritoneal dialysis patients: the European Body Composition Monitoring (EuroBCM) study cohort},
  url          = {http://dx.doi.org/10.1371/journal.pone.0017148},
  volume       = {6},
  year         = {2011},
}

Chicago
Van Biesen, Wim, John D Williams, Adrian C Covic, Stanley Fan, Kathleen Claes, Monika Lichodziejewska-Niemierko, Christian Verger, et al. 2011. “Fluid Status in Peritoneal Dialysis Patients: The European Body Composition Monitoring (EuroBCM) Study Cohort.” Plos One 6 (2).
APA
Van Biesen, W., Williams, J. D., Covic, A. C., Fan, S., Claes, K., Lichodziejewska-Niemierko, M., Verger, C., et al. (2011). Fluid status in peritoneal dialysis patients: the European Body Composition Monitoring (EuroBCM) study cohort. PLOS ONE, 6(2).
Vancouver
1.
Van Biesen W, Williams JD, Covic AC, Fan S, Claes K, Lichodziejewska-Niemierko M, et al. Fluid status in peritoneal dialysis patients: the European Body Composition Monitoring (EuroBCM) study cohort. PLOS ONE. 2011;6(2).
MLA
Van Biesen, Wim, John D Williams, Adrian C Covic, et al. “Fluid Status in Peritoneal Dialysis Patients: The European Body Composition Monitoring (EuroBCM) Study Cohort.” PLOS ONE 6.2 (2011): n. pag. Print.