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Relationship between bioimpedance-determined body composition and peritoneal transport in peritoneal dialysis

Relationship between bioimpedance-determined body composition and peritoneal transport in peritoneal dialysis

Int J Artif Organs 2017; 40(5): 212 - 218

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/ijao.5000584

Authors

Bernardo M. da Costa, Gloria Del Peso, Maria Auxiliadora Bajo, Gilda Carreño, Marta Ferreira, Carina Ferreira, Rafael Selgas

Abstract

Purpose

In peritoneal dialysis (PD) patients, body fluid homeostasis is dependent on peritoneal elimination of water and solutes. Patients with less favorable peritoneal transport parameters should be more overhydrated. Despite this, the association between faster transport and overhydration (OH) is weak, and the factors that influence hydration status are still poorly characterized. Modified peritoneal equilibration tests (PET) offer us new parameters that might correlate better with hydration status, like free water transport (FWT). The aim of this study was thus to establish the relationships between new peritoneal transport parameters and body composition parameters estimated by bioimpedance spectroscopy (BIS).

Methods

Prospective observational study on incident PD patients with a baseline and 1-year follow-up evaluation.

Results

61 patients were included in the baseline evaluation, 19 of whom had a 1-year follow-up evaluation; 67.2% were fluid overloaded. There was a negative correlation between D/P creatinine and FWT (r = -0.598, p = 0.000). The fraction of FWT was negatively correlated with OH (r = -0.302, p = 0.018). Peritoneal protein losses (PPL) were also correlated with OH (r = 0.287, p = 0.028). There were no significant differences in OH according to small-solute transport status or fluid output parameters. After 1 year, we observed a significant worsening of renal function and an improvement in 24-hour ultrafiltration (UF) and hydration status, but we detected no differences in peritoneal transport of water or solutes that could explain these changes.

Conclusions

There is a poor relationship between kidney/peritoneal function parameters and body composition parameters. The fraction of FWT and PPL may be underestimated markers of peritoneal health and of its contribution to the hydration status.

Article History

Disclosures

Financial support: This study has been supported in part with F.E.D.E.R. funds (REDinREN, RETICS, ISCIIII, Spanish Ministry of Health).
Conflict of interest: None of the authors has financial interest related to this study to disclose.

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Authors

Affiliations

  • Nephrology Department, Curry Cabral Hospital-Central Lisbon Hospital Center, Lisbon - Portugal
  • Nephrology Department, La Paz University Hospital, FIBHULP-IdiPAZ, Madrid - Spain

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