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Clinical and Experimental Nephrology

, Volume 20, Issue 5, pp 778–786 | Cite as

Extracellular volume expansion and the preservation of residual renal function in Korean peritoneal dialysis patients: a long-term follow up study

  • Harin Rhee
  • Min Ja Baek
  • Hyun Chul Chung
  • Jong Man Park
  • Woo Jin Jung
  • Soo Min Park
  • Jang Won Lee
  • Min Ji Shin
  • Il Young Kim
  • Sang Heon Song
  • Dong Won Lee
  • Soo Bong Lee
  • Ihm Soo Kwak
  • Eun Young SeongEmail author
Original Article

Abstract

Introduction

In chronic peritoneal dialysis patients, preservation of residual renal function (RRF) is a major determinant of patient survival, and maintaining sufficient intravascular volume has been hypothesized to be beneficial for the preservation of RRF. The present study aimed to test this hypothesis using multifrequency bioimpedence analyzer (MFBIA), in Korean peritoneal dialysis patients.

Methods

A total of 129 patients were enrolled in this study. The baseline MFBIA was checked, and the patients were divided into the following two groups: group 1, extracellular water per total body water (ECW/TBW) < median, group 2, ECW/TBW > median. We followed up the patients, and then we analyzed the changes in the urine output (UO) and the solute clearance (weekly uKt/V) in each group. Data associated with patient and technical survivor were collected by medical chart review. The volume measurement was made using Inbody S20 equipment (Biospace, Seoul, Korea). We excluded the anuric patients at baseline.

Result

The median value of ECW/TBW was 0.396. The mean patient age was 49.74 ± 10.01 years, and 62.1 % of the patients were male; most of the patients were on continuous ambulatory peritoneal dialysis (89.1 %). The mean dialysis vintage was 26.20 ± 28.71 months. All of the patients were prescribed hypertensive medication, and 48.5 % of the patients had diabetes. After 25.47 ± 6.86 months of follow up, ΔUO and Δweekly Kt/V were not significantly different in the two groups as follows: ΔUO (−236.07 ± 185.15 in group 1 vs −212.21 ± 381.14 in group 2, p = 0.756); Δ weekly Kt/v (−0.23 ± 0.43 in group 1 vs −0.29 ± 0.49 in group 2, p = 0.461). The patient and technical survivor rate was inferior in the group 2, and in the multivariable analysis, initial hypervolemia was an independent factor that predicts both of the patient mortality [HR 1.001 (1.001–1.086), p = 0.047] and the technical failure [HR 1.024 (1.001–1.048), p = 0.042].

Conclusions

Extracellular volume expansion, measured by MFBIA, does not help preserve residual renal function, and is harmful for the technical and patient survival in Korean peritoneal dialysis patients.

Keywords

Multifrequency bioimpedance analysis Peritoneal dialysis Residual renal function 

Notes

Acknowledgments

This study was supported by 2015 Clinical Research Grant from Pusan National University Hospital. We sincerely thank Dr. Keun Hyeun Lee at the Hemin Korean Traditional Medical Clinic for analyzing the data.

Compliance with ethical standards

Conflict of interest

All the authors have declared no competing interest.

Supplementary material

10157_2015_1203_MOESM1_ESM.docx (15 kb)
Supplementary material 1 (DOCX 14 kb)

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Copyright information

© Japanese Society of Nephrology 2015

Authors and Affiliations

  • Harin Rhee
    • 1
    • 2
  • Min Ja Baek
    • 3
  • Hyun Chul Chung
    • 4
  • Jong Man Park
    • 1
    • 2
  • Woo Jin Jung
    • 1
    • 2
  • Soo Min Park
    • 1
    • 2
  • Jang Won Lee
    • 1
    • 2
  • Min Ji Shin
    • 1
    • 2
  • Il Young Kim
    • 1
  • Sang Heon Song
    • 1
    • 2
  • Dong Won Lee
    • 1
  • Soo Bong Lee
    • 1
  • Ihm Soo Kwak
    • 1
    • 2
  • Eun Young Seong
    • 1
    • 2
    Email author
  1. 1.Department of Internal MedicinePusan National University School of MedicinePusanSouth Korea
  2. 2.Division of Nephrology, Biomedical Research InstitutePusan National University HospitalPusanSouth Korea
  3. 3.Department of Nursing ServicePusan National University School of MedicinePusanSouth Korea
  4. 4.Department of Internal MedicineUlsan University HospitalUlsanSouth Korea

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