title: Volume expansion and sodium balance in peritoneal dialysis patients. Part I: Recent concepts in pathogenesis.
abstract: Cardiovascular disease is a leading cause of death in patients with end-stage renal disease. Uncontrolled hypertension and volume expansion contribute to alternations in left ventricular geometry and are independent predictors of poor survival in dialysis patients. Excessive salt intake is a major handicap with loss of residual renal function. Sodium removal becomes inadequate in the face of declining residual renal function. Continued salt intake and inadequate sodium removal lead to volume expansion, which aggravates arterial hypertension. In part I of this two-part review, we consider information on dietary salt intake and its relationship to blood pressure and volume control in peritoneal dialysis (PD) patients. In addition, we review recently published studies on the use of various PD modalities to remove sodium, emphasizing the significance of volume expansion and uncontrolled hypertension in PD patients. Part II reviews the various measures available to enhance sodium and fluid removal in PD patients.
authors.affiliation: Division of Nephrology, University Health Network, Toronto, Ontario, Canada.
authors.forename: Mukesh
authors.initials: M
authors.lastname: Khandelwal
authors.forename: Jatin
authors.initials: J
authors.lastname: Kothari
authors.forename: Murali
authors.initials: M
authors.lastname: Krishnan
authors.forename: Vassilis
authors.initials: V
authors.lastname: Liakopoulos
authors.forename: Efstathia
authors.initials: E
authors.lastname: Tziviskou
authors.forename: Krishna
authors.initials: K
authors.lastname: Sahu
authors.forename: Carole
authors.initials: C
authors.lastname: Chatalalsingh
authors.forename: Joanne
authors.initials: J
authors.lastname: Bargman
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Oreopoulos
mesh_terms: D001835:Body Weight; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology; D010530:Peritoneal Dialysis / Q000009:adverse effects; D012964:Sodium / Q000378:metabolism*; D014883:Water-Electrolyte Imbalance / Q000209:etiology / Q000503:physiopathology*
chemical_list: D012964:Sodium