Volume status in patients on peritoneal dialysis: the role of apelin and bio-impedance spectroscopy.
One of the main factors determining the survival of peritoneal dialysis (PD) patients is volume status. We aimed to investigate hydration status of PD patients by bio-impedance spectroscopy (BIS) and echocardiography and to study the relation of them with apelin, which has effects related with volume status like vasodilation, positive inotropism, and inhibition of ADH release and RAS antagonism. Chronic PD patients without active cardiac disease or clinically prominent hypervolemia were included. Besides the demographic, clinical, and laboratory data, BIS and echocardiographic findings together with apelin levels were recorded. The study included 21 patients. Of them, eight patients were euvolemic, one patient was hypovolemic, and others have some degree of overhydration (1.1-6.8 L) with BIS, although all were euvolemic clinically. Mean apelin level was 1.49 ± 0.49 ng/mL. Apelin level was positively correlated with ejection fraction and negatively with total body water (TBW), intracellular and extracellular water, lean tissue mass, and left atrium diameter. On linear regression model, TBW was the major determinant of apelin. Although apelin is expected to increase in hypervolemic patients, the negative correlation with body water in this study may be related with yet unknown role of apelin in dialyzed patients. They may have important roles in volume status in future.
Department of Nephrology, Bezmialem Vakif University, Medical Faculty, Istanbul, Turkey.
Rumeyza
R
Kazancioglu
Meltem
M
Gursu
Serhat
S
Karadag
Emel
E
Tatli
Zeki
Z
Aydin
Sami
S
Uzun
Abdullah
A
Sumnu
Egemen
E
Cebeci
Savas
S
Ozturk
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000073861:Apelin; D001834:Body Water; D058266:Dielectric Spectroscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D014883:Water-Electrolyte Imbalance / Q000175:diagnosis* / Q000378:metabolism; D055815:Young Adult
C115436:APLN protein, human; D000073861:Apelin; D036341:Intercellular Signaling Peptides and Proteins