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

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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.

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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.

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Authors and Affiliations

  1. Department of Internal Medicine, Pusan National University School of Medicine, Pusan, South Korea

    Harin Rhee, 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 Seong

  2. Division of Nephrology, Biomedical Research Institute, Pusan National University Hospital, Gudeok-ro179, Seo-gu, Pusan, 602-739, South Korea

    Harin Rhee, Jong Man Park, Woo Jin Jung, Soo Min Park, Jang Won Lee, Min Ji Shin, Sang Heon Song, Ihm Soo Kwak & Eun Young Seong

  3. Department of Nursing Service, Pusan National University School of Medicine, Pusan, South Korea

    Min Ja Baek

  4. Department of Internal Medicine, Ulsan University Hospital, Ulsan, South Korea

    Hyun Chul Chung

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  1. Harin Rhee
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Correspondence to Eun Young Seong.

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Rhee, H., Baek, M.J., Chung, H.C. et al. Extracellular volume expansion and the preservation of residual renal function in Korean peritoneal dialysis patients: a long-term follow up study. Clin Exp Nephrol 20, 778–786 (2016). https://doi.org/10.1007/s10157-015-1203-2

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  • DOI: https://doi.org/10.1007/s10157-015-1203-2

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