title: Body composition, hydration, and related parameters in hemodialysis versus peritoneal dialysis patients.
abstract: OBJECTIVE
  Maintaining euvolemia is an important goal in patients on renal replacement therapy. However, adequate assessment of volume status in clinical practice is hampered by a lack of accurate measuring tools. A new multifrequency bioimpedance tool has recently been validated. This study compares volume status in peritoneal dialysis (PD) and hemodialysis (HD) patients in a single center.
  
  
  METHODS
  Body Composition Monitoring (BCM; Fresenius Medical Care, Bad Homburg, Germany) was performed in all patients on PD or HD without contraindication. PD patients were measured with a full abdomen; HD patients were measured at the midweek session, once immediately before and once 20 minutes after dialysis. Clinical overhydration was defined as an overhydration-to-extracellular water ratio of >0.15.
  
  
  RESULTS
  Total body water, extracellular water, and intracellular water were 33.7 +/- 6.9 L versus 31.8 +/- 8.1 L vs 33.9 +/- 6.7 L, 16.4 +/- 3.9 L vs 15.3 +/- 4.9 L vs 16.8 +/- 3.3 L, and 17.1 +/- 6.2 L vs 16.5 +/- 4.6 L vs 17.2 +/- 3.9 L in the pre-HD, post-HD, and PD patients, respectively (p = NS). In the pre-HD and the PD patients, overhydration was 1.9 +/- 1.7 L and 2.1 +/- 2.3 L, whereas post-HD this was only 0.6 +/- 1.7 L (p < 0.001). Clinical overhydration was more prevalent in pre-HD and PD patients compared to post-HD patients (24.1% vs 22.3% vs 10%, p < 0.001). In multivariate models, overhydration was related to age, male gender, and post-HD status.
  
  
  CONCLUSIONS
  Although much clinical attention is paid to volume status, 24% of patients still have clinically relevant volume overload. Implementation of a reliable and clinically applicable tool to assess volume status is therefore necessary. It is possible to obtain comparable volume status in PD and HD patients.
authors.affiliation: Renal Division, University Hospital Ghent, Ghent, Belgium.
authors.forename: Isabel
authors.initials: I
authors.lastname: Devolder
authors.forename: Annick
authors.initials: A
authors.lastname: Verleysen
authors.forename: Denise
authors.initials: D
authors.lastname: Vijt
authors.forename: Raymond
authors.initials: R
authors.lastname: Vanholder
authors.forename: Wim
authors.initials: W
authors.lastname: Van Biesen
mesh_terms: D000368:Aged; D001823:Body Composition; D001834:Body Water; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010530:Peritoneal Dialysis; D006435:Renal Dialysis