Abstract
Assessment of hydration status is essential in monitoring the effectiveness of renal replacement therapy and is usually based on physical examination. However, comparisons of hydration status achieved with different dialysis methods are not conclusive. We compared the hydration status of patients on chronic hemodialysis (HD, n = 60) and peritoneal dialysis (PD, n = 20) in a comprehensive assessment including physical examination and additional methods. The mean age of the 80 chronically dialyzed patients (53 males, 27 females) was 58.1 ± 13.9 years. The clinical evaluation took into account the presence of peripheral edema, dyspnea, and crackling over the lung fields. Additional tests included lung ultrasound, electrical bioimpedance (performed in 79 patients), impedance cardiography, ultrasound assessment of large abdominal vessels (performed in 79 patients), select echocardiographic parameters (obtained in 78 patients), and serum NT-proBNP concentration. Residual diuresis volume was significantly higher in the PD group. We found no significant differences between the two groups in any other baseline characteristics or in the results of the clinical examination or additional tests. The use of different methods for assessing hydration does not allow differentiation of patients treated with dialysis in terms of the dialysis technique used. Therefore, it seems reasonable to use common algorithms to objectify the hydration status of these patients.
Highlights
End-stage renal disease is characterized by a number of abnormalities that disrupt the body’s homeostasis
To the best of our knowledge, this study is the first to compare the hydration status of peritoneal dialysis (PD) and HD patients using a number of complementary diagnostic methods: clinical examination; assessment of fluid content in the chest by two methods (LUS and impedance cardiography (ICG)); and intravascular volemia including myocardial overload (ECHO), IVCDi, IVCCi, NT-pro-BNP, and body composition monitoring (BCM)
In PD patients, the volume of ultrafiltration depends on hydration status, peritoneal properties, and the type of dialysis fluid
Summary
End-stage renal disease is characterized by a number of abnormalities that disrupt the body’s homeostasis. Overhydration is a important problem, especially in patients on dialysis. In less advanced stages of chronic kidney disease (CKD), overhydration accelerates the loss of renal function and the time to start renal replacement therapy [1]. Overhydration increases arterial stiffness and left ventricular hypertrophy, leading to the development of hypertension and heart failure [2]. The condition is associated with an increase in total and cardiovascular mortality in both hemodialysis (HD) and peritoneal dialysis (PD) patients [3,4,5,6]. The clinical consequences of overhydration justify considering water as a uremic toxin [7].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
