title: Overhydration prevalence in peritoneal dialysis - A 2 year longitudinal analysis.
abstract: OBJECTIVE
  Hypervolemia is a major concern in dialysis patients, and is associated with increased cardiovascular risk and death. Cross sectional analysis have previously demonstrated that peritoneal dialysis (PD) patients are not more overhydrated when compared to haemodialysiś ones. This study was designed to evaluate longitudinal trends in hydration status and corporal composition in a PD population.
  
  
  METHODS
  We conducted a 2 year prospective observational study of 58 PD patients from a single centre. Incident and prevalent patients were included. Yearly measurements were performed using multifrequency electric bioimpedance. Overhydration (OH) was defined as an extra-cellular water (ECW)/total body water (TBW) over 15%. Clinical and biochemical variables were also explored.
  
  
  RESULTS
  A total of 30 patients completed evaluation (female 63.3%, mean age 56.9 years, BMI 25.0 kg/m², diabetes 10.0%, APD-50.0%). Median PD vintage was 21.9 months, and 36.7% were anuric. At baseline 6.7% were overhydrated. On longitudinal analysis no significant changes were found in hydration status, systolic blood pressure, pro-BNP, nor albumin levels. Similar results were found among incident (n=11; APD- 45.5%; anuric- 9.1%) and prevalent (n=19; APD- 52.6%; anuric- 52.6%) patients (p>.05). However, at the second year, prevalent patients were moderately overhydrated compared to incident ones (median 10.2% vs 3.5%; p=.009). Nonetheless, no statistical difference was observed considering adequacy, TBW, or ECW. Moreover, nutritional parameters remained stable.
  
  
  CONCLUSIONS
  Peritoneal dialysis maintenance without increasing volume status, nor major deleterious corporal composition trends, is feasible under careful therapy strategies. Longitudinal application of BIA may be a useful clinical tool to evaluate adequacy beyond Kt/V.
authors: Department of Nephrology. Hospital de Santo António. Centro Hospitalar do Porto. Porto (Portugal). Electronic address: pedro.ventura.aguiar@gmail.com.
authors: Pedro Ventura
authors: PV
authors: Aguiar
authors: Department of Nephrology. Hospital de Santo António. Centro Hospitalar do Porto. Porto (Portugal).
authors: Olívia
authors: O
authors: Santos
authors: Instituto Ciencias Biomédicas Abel Salazar. Universidade Porto. Porto (Portugal).
authors: Laetitia
authors: L
authors: Teixeira
authors: Department of Nephrology. Hospital de Santo António. Centro Hospitalar do Porto. Porto (Portugal).
authors: Fernanda
authors: F
authors: Silva
authors: Department of Nephrology. Hospital de Santo António. Centro Hospitalar do Porto. Porto (Portugal).
authors: Pedro
authors: P
authors: Azevedo
authors: Department of Nephrology. Hospital São Teotónio. Viseu (Portugal).
authors: Joana
authors: J
authors: Vidinha
authors: Department of Nephrology. Centro Hospitalar Medio-Tejo. Torres Novas (Portugal).
authors: Francisco
authors: F
authors: Ferrer
authors: Department of Nephrology. Hospital de Santo António. Centro Hospitalar do Porto. Porto (Portugal); Instituto Ciencias Biomédicas Abel Salazar. Universidade Porto. Porto (Portugal).
authors: Maria João
authors: MJ
authors: Carvalho
authors: Department of Nephrology. Hospital de Santo António. Centro Hospitalar do Porto. Porto (Portugal).
authors: António
authors: A
authors: Cabrita
authors: Department of Nephrology. Hospital de Santo António. Centro Hospitalar do Porto. Porto (Portugal); Instituto Ciencias Biomédicas Abel Salazar. Universidade Porto. Porto (Portugal).
authors: Anabela
authors: A
authors: Rodrigues
mesh_terms: D000328:Adult; D001823:Body Composition; D004231:Diuresis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000706:statistics & numerical data; D015995:Prevalence; D011446:Prospective Studies; D014883:Water-Electrolyte Imbalance / Q000453:epidemiology / Q000209:etiology*
keywords: Bioimpedancia; Diálisis Peritoneal; Hipertensión; Hypertension; Multifrequency bioimpedance; Nutrición; Nutritional status; Overhydration; Peritoneal dialysis; Prescribed dialysis dose; Prescripción; Sobrehidratación; Volume status; Volumen