P1195ASSESSMENT OF BODY FLUID VOLUME USING THE BIOIMPEDANCE METHOD IN PERITONEAL DIALYSIS PATIENTS

Abstract

Abstract Background and Aims ppropriate maintenance of body fluid balance in peritoneal dialysis (PD) patients is important for the amelioration of cardiovascular complications and prognosis. In recent years, the usefulness of body fluid measurement with the bioimpedance method in PD patients has been reported. Meanwhile, peritoneal permeability plays an important role in maintaining body fluid balance in PD patients. In the present study, we examined the correlation between peritoneal permeability and body fluid volume in PD patients. Method A total of 58 patients who were undergoing PD at our hospital (42 men and 16 women; mean age, 68 ± 16.2 years; mean dialysis history, 63.5 ± 144.9 months; 25 DM and 35 non-DM patients). Overhydration (OH), total body water (TBW) volume, extracellular water (ECW) volume, and lean tissue mass (LTM) were measured using a body composition analyzer (BCM Fresenius Medical Care Japan). At the same time, peritoneal permeability was measured with fast peritoneal equilibration test to determine the dialysate-to-plasma ratio for creatinine (D/P-Cr), and its correlations with sex, age, age at the time of introduction of dialysis, dialysis history, diabetes history, brain natriuretic peptide (BNP) level, high-sensitivity troponin I (hsTnI) level, blood pressure, body weight, residual kidney function, and ultrafiltration were examined. Results The mean OH was 2.53 ± 2.44 L, and 8 patients (13.8%) had an OH of ≤1.1 L. The results of the multivariate analysis revealed that OH positively correlated with the presence or absence of diabetes, ultrafiltration, D/P-Cr, BNP level, hsTnI level, TBW, and ECW, but showed no correlation with sex, dialysis history, age, age at the time of introduction of dialysis, residual renal function, or LTM. Furthermore, the subjects were assigned to D/P-Cr ≥ 0.65 and ≤0.65 groups. In the former, OH correlated with diabetes and male sex by being negatively correlated with age and age at the time of introduction of dialysis and positively correlated with BNP level, hsTnI level, TBW, and ECW. However, in the D/P-Cr ≤ 0.65 group, OH positively correlated with BNP level and ECW. Conclusion Our results suggest that youth, complications of DM, and men are at risk for fluid overload in PD patients with increased peritoneal permeability.