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

(2011) PLOS ONE. 6(2).
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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.
Keywords
RESIDUAL RENAL-FUNCTION, BIOIMPEDANCE SPECTROSCOPY, CHRONIC KIDNEY-DISEASE, HEMODIALYSIS-PATIENTS, ANURIC PATIENTS, BLOOD-PRESSURE, CAPD PATIENTS, VOLUME, MANAGEMENT, SURVIVAL

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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.
@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},
}

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