title: Total body water reduction in subjects with chronic kidney disease on peritoneal dialysis is associated with a better hypertension control.
abstract: BACKGROUND
  Hypertension is highly prevalent in patients with chronic kidney disease and hypervolemia is one of the principal causes.
  
  
  OBJECTIVE
  To evaluate the influence of the reduction of volemia on blood pressure as well as on echocardiographic parameters in patients on continuous ambulatory peritoneal dialysis.
  
  
  METHODS
  Twelve patients with no clinical evidence of hypervolemia were submitted to an increase in the rate of the dialysis with the purpose of reducing body weight by 5%. The volemia was evaluated by electrical bioimpedance and by ultrasound of the inferior cava vena (ICV). Blood pressure was measured by ambulatory blood pressure monitoring and cardiac function was evaluated by echocardiography both at baseline and 5 weeks after the intervention period.
  
  
  RESULTS
  After the increase in the ultrafiltration, body weight, extracellular water and the inspiratory diameter of the ICV decreased significantly in parallel with a non-significant increase in the collapsing ICV index. Despite the reduction of anti-hypertensive drugs, systolic blood pressure during the sleep period decreased from 138.4 ± 18.6 to 126.7 ± 18.0 mmHg, the nocturnal blood pressure drop increased and the final systolic left ventricular diameter decreased significantly.
  
  
  CONCLUSIONS
  Reduction of the volemia of patients on peritoneal dialysis, with no signs of hypervolemia, was associated with a better blood pressure control and with a decrease of the final systolic left ventricular diameter.
authors.affiliation: Instituto do Coração.
authors.forename: José Resende
authors.initials: JR
authors.lastname: de Castro Júnior
authors.affiliation: Universidade Federal de Juiz de Fora.
authors.forename: Natália
authors.initials: N
authors.lastname: Fernandes
authors.affiliation: Universidade Federal de Juiz de Fora.
authors.forename: Thiago Bento de Paiva
authors.initials: TB
authors.lastname: Lacet
authors.affiliation: Hospital São João de Deus.
authors.forename: Fábio Simplício
authors.initials: FS
authors.lastname: Maia
authors.affiliation: Hospital Santa Marcelina.
authors.forename: Glauco Resende
authors.initials: GR
authors.lastname: Bonato
authors.affiliation: Universidade Federal de Juiz de Fora.
authors.forename: Cristianne
authors.initials: C
authors.lastname: Nogueira
authors.affiliation: Pontifícia Universidade Católica do Paraná.
authors.forename: Sílvio Henrique
authors.initials: SH
authors.lastname: Barberato
authors.affiliation: Universidade Federal de Juiz de Fora.
authors.forename: Rogério Baumgratz
authors.initials: RB
authors.lastname: de Paula
mesh_terms: D001834:Body Water; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000628:therapy*