SP514The effect of strict volume control assessed by serial bioimpedance spectroscopy measurement on cardiac function in peritoneal dialysis patients

AbstractAdequate fluid management plays an important role in decreasing cardiovascular risk in peritoneal dialysis (PD) patients. We evaluated whether strict volume control monitored by bioimpedance spectroscopy (BIS) affects cardiac function in PD patients. This study is a secondary analysis of a multicentre, prospective, randomized, controlled trial. Fluid overload was assessed by the average overhydration/extracellular water (OH/ECW) at baseline, 6 months and 12 months. Patients were categorized as time-averaged overhydrated (TA-OH/ECW ≥15%) or normohydrated (TA-OH/ECW <15%), and echocardiographic parameters were compared between groups. Among a total of 151 patients, 120 patients exhibited time-averaged normohydration. Time-averaged overhydrated patients had a significantly higher left atrial (LA) diameter and E/e′ ratio and a lower left ventricular (LV) ejection fraction at 12 months than time-averaged normohydrated patients. LA diameter, end-systolic volume and end-diastolic volume were decreased at 12 months compared to baseline in time-averaged normohydrated patients only. TA-OH/ECW was independently associated with ejection fraction at 12 months (β = −0.190; p = 0.010). TA-OH/ECW, but not OH/ECW at 12 months, was an independent risk factor for LV dysfunction (odds ratio 4.020 [95% confidence interval 1.285–12.573]). Overhydration status based on repeated BIS measurements is an independent predictor of LV systolic function in PD patients.

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Impact of Volume Management on Volume Overload and Rehospitalization in CAPD Patients

Western Journal of Nursing Research ◽

10.1177/0193945916683652 ◽

2016 ◽

Vol 40 (5) ◽

pp. 725-737 ◽

Cited By ~ 1

Author(s):

Yi Xu ◽

Shen-Min Yang ◽

Xiao-hua Wang ◽

Hai-fang Wang ◽

Mei-e Niu ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Cardiac Function ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Management Strategy ◽

Intervention Group ◽

Volume Overload ◽

Volume Control ◽

Control Group ◽

Dialysis Patients ◽

Volume Management

Heart failure due to volume overload is a major reason for rehospitalization in continuous ambulatory peritoneal dialysis patients. Strict volume control provides better cardiac functions and blood pressure in this population. Volume management, which is a volume control strategy, may decrease volume overload and related complications. Using a quasi-experimental design, 66 continuous ambulatory peritoneal dialysis patients were randomly assigned to the intervention group ( n = 34) and control group ( n = 32). The patients were followed up for 6 months with scheduled clinic and/or telephone visits; the intervention group adopted volume management strategy, while the control group adopted conventional care. Volume overload and cardiac function were compared between the two groups at the baseline and at 6 months. At Month 6, the intervention group resulted in significant improvement in volume overloaded status, cardiac function, and volume-overload-related rehospitalization. Volume management strategy allows for better control of volume overload and is associated with fewer volume-related readmissions.

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Effects of l-Carnitine Supplementation in Patients Receiving Hemodialysis or Peritoneal Dialysis

Nutrients ◽

10.3390/nu12113371 ◽

2020 ◽

Vol 12 (11) ◽

pp. 3371 ◽

Cited By ~ 1

Author(s):

Masako Kuwasawa-Iwasaki ◽

Hiroaki Io ◽

Masahiro Muto ◽

Saki Ichikawa ◽

Keiichi Wakabayashi ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Cardiac Function ◽

Acid Metabolism ◽

Carnitine Deficiency ◽

Muscle Spasm ◽

Free Carnitine ◽

Carnitine Supplementation ◽

Dialysis Patients ◽

Muscle Spasms ◽

Total Carnitine

l-carnitine is an important factor in fatty acid metabolism, and carnitine deficiency is common in dialysis patients. This study evaluated whether l-carnitine supplementation improved muscle spasm, cardiac function, and renal anemia in dialysis patients. Eighty Japanese outpatients (62 hemodialysis (HD) patients and 18 peritoneal dialysis (PD) patients) received oral l-carnitine (600 mg/day) for 12 months; the HD patients further received intravenous l-carnitine injections (1000 mg three times/week) for 12 months, amounting to 24 months of treatment. Muscle spasm incidence was assessed using a questionnaire, and cardiac function was assessed using echocardiography. Baseline free carnitine concentrations were relatively low in patients who underwent dialysis for >4 years. Total carnitine serum concentration, free carnitine, and acylcarnitine significantly increased after oral l-carnitine treatment for 12 months, and after intravenous l-carnitine injection. There was no significant improvement in muscle spasms, although decreased muscle cramping after l-carnitine treatment was reported by 31% of patients who had undergone HD for >4 years. Hemoglobin concentrations increased significantly at 12 and 24 months in the HD group. Therefore, l-carnitine may be effective for reducing muscle cramping and improving hemoglobin levels in dialysis patients, especially those who have been undergoing dialysis for >4 years.

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