Weight Limitations for Weekly Urea Clearances Using Various Exchange Volumes in Continuous Ambulatory Peritoneal Dialysis

1994 ◽  
Vol 14 (3) ◽  
pp. 261-264 ◽  
Author(s):  
Karl D. Nolph ◽  
Richard A. Jensen ◽  
Ramesh Khanna ◽  
Zbylut J. Twardowski
Keyword(s):  
Body Weight ◽  
Peritoneal Dialysis ◽  
Outcome Measures ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Total Body Water ◽  
Theoretical Calculations ◽  
Plasma Urea ◽  
Graphic Form ◽  
Anephric Patients ◽  
Total Body

Objective To calculate the relationships of weekly KT/V urea to standard body weight with different exchange volumes (2, 2.5, or 3 L) for continuous ambulatory peritoneal dialysis (CAPD) in functionally a nephric patients and to display the results in graphic form. Design Theoretical calculations using previously measured 24-hour dialysate/plasma urea values in 77 CAPD patients and other defined components of weekly KT/V urea. Setting Measurements and calculations in theoretical patients doing standard CAPD with four daily exchanges. Patients Theoretical functionally anephric patients on standard CAPD as above. Interventions Theoretical calculations based on instillation of 2-, 2.5-, and 3-L exchange volumes. Main Outcome Measures Weekly urea clearances normalized to total body water (weekly KT/V urea). The values using different exchange volumes were related to standard body weight. Results Although a minimum recommended weekly KT/V urea target is arbitrary, the results illustrate the range of flexibility of CAPD relative to KT/V urea values with variations in exchange volume. The standard weights above which anephric patients on CAPD using four exchanges per day with 2-, 2.5-, and 3-L exchanges cannot reach a weekly KT/V urea target of 1.7, have been identified. The range of weekly KT/V urea levels possible with different exchange-volume programs has been graphically illustrated. Conclusions Weights above which a weekly KT/V urea of 1.7 cannot be reached in functionally anephric patients are 64, 77.6, and 91 kg for CAPD using 2-, 2.5-, and 3- L exchanges, respectively.

Nutritional Status of Patients Undergoing Continuous Ambulatory Peritoneal Dialysis (CAPD)

1983 ◽  
Vol 3 (3) ◽  
pp. 138-141 ◽  
Author(s):  
Brigitte Heide ◽  
Andreas Pierratos ◽  
Ramesh Khanna ◽  
Jean Pettit ◽  
Raymond Ogilvie ◽  
...  
Keyword(s):  
Body Weight ◽  
Peritoneal Dialysis ◽  
Nutritional Status ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Protein Intake ◽  
Biochemical Parameters ◽  
Total Body Potassium ◽  
Total Body ◽  
Over Time

Nutritional follow-up of 20 CAPD patients for 18–24 months showed a decrease in total body nitrogen, increase in total body potassium and body weight, and a decrease in protein intake over time. There was no correlation between changes in TBN and the biochemical parameters measured. Serial dietetic assessments and measurements of total body nitrogen as well as adherence to an adequate protein intake will assist in the prevention of malnutrition in CAPD patients.

Weekly Clearances of Urea and Creatinine on CAPD and NIPD

1992 ◽  
Vol 12 (3) ◽  
pp. 298-303 ◽  
Author(s):  
Karl D. Nolph ◽  
Zbylut J. Twardowski ◽  
Prakash R. Keshaviah1
Keyword(s):  
Peritoneal Dialysis ◽  
Creatinine Clearance ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Total Body Water ◽  
Clinical Implications ◽  
Urea Clearance ◽  
Short Cycle ◽  
Future Studies ◽  
Long Cycle ◽  
Total Body

Weekly creatinine clearance (Ccr) and weekly Curea/ v (kt/v) are popular indices for quantitating the amount of peritoneal dialysis provided. Studies were undertaken on 44 patients on continuous ambulatory peritoneal dialysis (CAPD) and 10 patients on nightly intermittent peritoneal dialysis (NIPD) to compare relationships of weekly creatinine clearance to weekly urea clearance (Curea) divided by total body water (v). With a long cycle therapy such as CAPD, the ratio of weekly Ccr to weekly kt/v is higher than with a short cycle technique, such as NIPD, in the same patient. If patients are shifted from CAPD to NIPD maintaining the same weekly kt/v, the weekly Ccr will decrease. If patients are shifted from CAPD to NIPD maintaining the same weekly Ccr, then the weekly kt/v will increase. The clinical implications of these observations are unknown, but should be kept in mind for future studies comparing CAPD and NIPD.

Indirect Measures of Total Body Water May Confound Precise Assessment of Peritoneal Dialysis Adequacy

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 224-226 ◽  
Author(s):  
Rebecca Schmidt ◽  
Francis Dumler ◽  
Cosme Cruz
Keyword(s):  
Body Weight ◽  
Peritoneal Dialysis ◽  
Total Body Water ◽  
Electrical Conductance ◽  
Bioelectrical Impedance ◽  
Body Water ◽  
Dialysis Adequacy ◽  
Indirect Measures ◽  
Body Weights ◽  
Total Body

Urea kinetic modeling (UKM) has yet to be optimized as a practical tool for assessing adequacy of therapy In continuous ambulatory peritoneal dialysis (CAPO) patients. Watson equation (WV) and 58% body weight (58%WT) estimates of total body water (TBW) are Indirect measures likely to yield Imprecise estimates of Kt/V. Bioelectrical Impedance (BEl) measures body composition as a function of electrical conductance, minimizing fat contribution to TBW. TBW values were highest when measured as 58%WT and lowest when calculated from WV. These differences were most striking In patients with overweight body habitus. BEI-derived TBW correlated best with UKM values. The relationship between BEI-derived and anthropometrically derived TBW was best In patients of normal habitus. Kt/V values were highest when calculated from WV-derived volumes and significantly differed from Kt/V values calculated from BEI-derived and 58%WT volumes. When segregated by habitus, however, only In overweight patients was this pattern of clinical significance. Serial body weight, lean body mass, and TBW remained stable In patients of normal habitus. Overweight patients increased weight by 5%, lean mass by 2%, and TBW by 5%, 3%, and 2% when measured by 58%WT, WV, and BEl, respectively. BEl measures of TBW exclude fat mass and thus strengthen the use of Kt/V for assessing dialysis adequacy In CAPO patients of all body weights.

scholarly journals Effects of a 14-Day Hydration Intervention on Individuals with Habitually Low Fluid Intake

2021 ◽  
Author(s):  
Aaron R. Caldwell ◽  
Megan E. Rosa-Caldwell ◽  
Carson Keeter ◽  
Evan C. Johnson ◽  
François Péronnet ◽  
...  
Keyword(s):  
Body Weight ◽  
Total Body Water ◽  
Fluid Intake ◽  
Urine Volume ◽  
Urine Osmolality ◽  
Body Water ◽  
Control Group ◽  
Intervention Phase ◽  
Total Body ◽  
Experimental Group

<b><i>Background:</i></b> Debate continues over whether or not individuals with low total water intake (TWI) are in a chronic fluid deficit (i.e., low total body water) [<xref ref-type="bibr" rid="ref1">1</xref>]. When women with habitually low TWI (1.6 ± 0.5 L/day) increased their fluid intake (3.5 ± 0.1 L/day) for 4 days 24-h urine osmolality decreased, but there was no change in body weight, a proxy for total body water (TBW) [<xref ref-type="bibr" rid="ref2">2</xref>]. In a small (<i>n</i> = 5) study of adult men, there were no observable changes in TBW, as measured by bioelectrical impedance, after increasing TWI for 4 weeks [<xref ref-type="bibr" rid="ref3">3</xref>]. However, body weight increased and salivary osmolality decreased indicating that the study may have been underpowered to detect changes in TBW. Further, no studies to date have measured changes in blood volume (BV) when TWI is increased. <b><i>Objectives:</i></b> Therefore, the purpose of this study was to identify individuals with habitually low fluid intake and determine if increasing TWI, for 14 days, resulted in changes in TBW or BV. <b><i>Methods:</i></b> In order to identify individuals with low TWI, 889 healthy adults were screened. Participants with a self-reported TWI less than 1.8 L/day (men) or 1.2 L/day (women), and a 24-h urine osmolality greater than 800 mOsm were included in the intervention phase of the study. For the intervention phase, 15 participants were assigned to the experimental group and 8 participants were assigned to the control group. The intervention period lasted for 14 days and consisted of 2 visits to our laboratory: one before the intervention (baseline) and 14 days into the intervention (14-day follow-up). At these visits, BV was measured using a CO-rebreathe procedure and deuterium oxide (D<sub>2</sub>O) was administered to measure TBW. Urine samples were collected immediately prior, and 3–8 h after the D<sub>2</sub>O dose to allow for equilibration. Prior to each visit, participants collected 24-h urine to measure 24-h hydration status. After the baseline visit, the experimental group increased their TWI to 3.7 L for males and 2.7 L for females in order to meet the current Institute of Medicine recommendations for TWI. <b><i>Results:</i></b> Twenty-four-hour urine osmolality decreased (−438.7 ± 362.1 mOsm; <i>p</i> &#x3c; 0.001) and urine volume increased (1,526 ± 869 mL; <i>p</i> &#x3c; 0.001) in the experimental group from baseline, while there were no differences in osmolality (−74.7 ± 572 mOsm; <i>p</i> = 0.45), or urine volume (−32 ± 1,376 mL; <i>p</i> = 0.89) in the control group. However, there were no changes in BV (Fig. <xref ref-type="fig" rid="f01">1</xref>a) or changes in TBW (Fig. <xref ref-type="fig" rid="f01">1</xref>b) in either group. <b><i>Conclusions:</i></b> Increasing fluid intake in individuals with habitually low TWI increases 24-h urine volume and decreases urine osmolality but does not result in changes in TBW or BV. These findings are in agreement with previous work indicating that TWI interventions lasting 3 days [<xref ref-type="bibr" rid="ref2">2</xref>] to 4 weeks [<xref ref-type="bibr" rid="ref3">3</xref>] do not result in changes in TBW. Current evidence would suggest that the benefits of increasing TWI are not related changes in TBW.

Estimation of water content by tritium dilution of animals subjected to rapid live-weight changes

1969 ◽  
Vol 72 (1) ◽  
pp. 31-40 ◽  
Author(s):  
W. R. McManus ◽  
R. K. Prichard ◽  
Carolyn Baker ◽  
M. V. Petruchenia
Keyword(s):  
Body Weight ◽  
Water Content ◽  
Total Body Water ◽  
Compensatory Growth ◽  
Specific Activity ◽  
Tritiated Water ◽  
Body Water ◽  
Under Nutrition ◽  
The Mean ◽  
Total Body

SUMMARYThe use of tritiated water to estimate total body-water content of animals experiencing recovery from under-nutrition was studied.The time for equilibration of tritiated water (TOH), given intraperitoneally, with total body water (TBW) was determined in rabbits and in rats. As judged by the specific activity of blood water, equilibration had occurred by 76–125 min in the rabbit and did not appear to be affected by the plane of nutrition. However, between slaughter groups the specific activity of water obtained from the liver 180 min after injection of TOH was significantly different from the specific activity of water simultaneously obtained from the blood plasma. It is concluded that the liver is not a suitable tissue to use for testing achievement of equilibration.As judged by the specific activity of blood water compared to that of water from the whole body macerate, equilibration in mature rats either in stable body condition or undergoing rapid compensatory growth occurred in less than 60 min.A trial comparing TOH-space (corrected by 3% body weight) and actual TBW (by desiccation) was conducted on thirty rabbits which experienced under-nutrition followed by compensatory growth.Prior to under-nutrition the agreement between actual and estimated TBW was satisfactory and within 2·3%. During compensatory growth the agreement was poor— the TOH values over-estimating actual TBW by about 12%.A trial with mature rats confirmed the findings with rabbits. For rats in stable body weight the mean estimated TOH-space for fourteen animals was within 1·2% of the actual TBW. For fourteen rats undergoing compensatory growth the mean estimated TOH-space (corrected by 3% body weight) overestimated actual TBW by 6·2%.

The Effect of Serum Albumin at the Start of Continuous Ambulatory Peritoneal Dialysis Treatment on Patient Survival

1994 ◽  
Vol 14 (2) ◽  
pp. 121-126 ◽  
Author(s):  
Dirk G. Struijk ◽  
Raymond T. Krediet ◽  
Gerardus C.M. Koomen ◽  
Elisabeth W. Boeschoten ◽  
Lambertus Arisz
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Patient Survival ◽  
Cox Model ◽  
Medical Center ◽  
Systemic Disease ◽  
Ideal Body Weight ◽  
Plasma Urea ◽  
Lower Survival Rate

Objective To analyze the effect of serum albumin using immunoturbidimetry, demographic, biochemical, and kinetic factors on survival of continuous ambulatory peritoneal dialysis (CAPD) patients. Design A review of prospectively collected data in a 2-year follow-up study of peritoneal transport kinetics. Setting University medical center. Participants Sixty-one patients, evaluated within 3 months after the start of CAPD. Main Outcome Measures Covariables used in the survival analysis were plasma urea, and creatinine, albumin, hemoglobin, mass transfer area coefficient of creatinine, peritoneal albumin clearance, 4-hour peritoneal albumin loss, net ultrafiltration, age, blood pressure, body mass index, difference between actual and ideal body weight, and presence or absence of systemicdisease. Results Overall survival was 64% at 2 years. Median serum albumin was 30.9 g/L, range 18.1 -43.9 g/L. Patients with a serum albumin below the median had a lower survival rate than those higher than the median (2-year survival 49% vs 79%, p = 0.01). Using the Cox model, survival was related to systemic disease (p = 0.004), age (p = 0.02), hemoglobin (p = 0.03), and serum albumin (p = 0.1). Conclusions The results confirm the strength of serum albumin as predictor of survival. However, in this study serum albumin merely reflected the presence of a systemic disease, which was the most important risk factor for patient survival.

Variability of Peritoneal Protein Loss in Diabetic and Nondiabetic Patients on Continuous Ambulatory Peritoneal Dialysis

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 242-244 ◽  
Author(s):  
Sophia Spaia ◽  
Fotini Christidou ◽  
Panayotis Pangidis ◽  
Thomas Tsoulkas ◽  
Michalis Pazarloglou ◽  
...  
Keyword(s):  
Body Weight ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Total Protein ◽  
Peritoneal Fluid ◽  
Protein Loss ◽  
Glucose Levels ◽  
Short Period ◽  
Group A ◽  
Group B

In order to evaluate the Influence of diabetes mellitus on peritoneal membrane permeability, we studied the peritoneal protein loss In two groups of patients. Group A consisted of 16 patients (9 nondlabetics and 7 diabetics) who were In the first month of treatment on continuous ambulatory peritoneal dialysis (CAPO). Group B consisted of 13 patients (7 nondlabetics and 6 diabetics) who had been on CAPO for approximately 15 months. In both groups we measured the body weight, serum total protein, albumin, and total protein, urea, and glucose In the peritoneal fluid. We did not find any difference In groups A and B between diabetics and nondlabetics as far as the estimated parameters were concerned. Age, body weight, serum biochemistry, and protein and urea content In peritoneal fluid were similar, when group A was compared to group B. Patients of group B hed on average higher protein losses than those who had been on the method for a short period (mean 7.9 g/dL, vs 6.09 g/dL). Six patients were followed for over 15 months and were found to have significantly Increased protein losses (p=0.02). Glucose levels In peritoneal fluid were significantly lower In patients In group B, p<0.05 (mean 51.8 g/dL vs 37.1 g/dL). Peritoneal protein loss does not seem to differ between diabetic and nondiabetic patients with end-stage renal disease treated with CAPO, at any given time of the treatment. We observed an Increase In protein loss In some patients and a tendency to Increase the protein loss In others. This, along with the fall In glucose levels, might reflect progressive alterations In structure and permeability of the elements Involved In peritoneal transport, and It should receive further evaluation.

Peritoneal Absorption of Vancomycin during and after Resolution of Peritonitis in Continuous Ambulatory Peritoneal Dialysis (CAPO) Patients

1988 ◽  
Vol 8 (2) ◽  
pp. 135-136 ◽  
Author(s):  
B. Bastani ◽  
D. A. Spyker ◽  
F. B. Westervelt
Keyword(s):  
Body Weight ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Half Life ◽  
Loading Dose

We studied the absorption of i.p. loading dose of vancomycin (30 mg/kg of body weight) in five continuous ambulatory peritoneal dialysis (CAPD) patients, both at the time of peritonitis and after its resolution. Mean vancomycin absorption after 6 h of i.p. dwell was 74% from inflamed and 51% from noninflamed peritoneum. Mean peritoneal absorption half-life of vancomycin was 3.2 and 7.2 h in the inflamed vs. non inflamed peritoneum, respectively.

Vancomycin Removal during High-Volume Peritoneal Dialysis in Acute Kidney Injury Patients

2019 ◽  
Vol 39 (2) ◽  
pp. 183-187 ◽  
Author(s):  
Daniela Ponce ◽  
Welder Zamoner ◽  
Fernanda Moreira Freitas ◽  
André Balbi ◽  
Linda Awdishu
Keyword(s):  
Acute Kidney Injury ◽  
Body Weight ◽  
Peritoneal Dialysis ◽  
Kidney Injury ◽  
High Volume ◽  
Total Body Weight ◽  
Empirical Treatment ◽  
Total Body

Studies on vancomycin pharmacokinetics in acute kidney injury (AKI) patients on high-volume peritoneal dialysis (HVPD) are lacking. We studied the pharmacokinetics of intravenous (IV) vancomycin in AKI patients treated by HVPD who received a prescribed single IV dose of vancomycin (15 - 20 mg/kg total body weight) to determine the extent of vancomycin removal and to establish vancomycin dosing guidelines for the empirical treatment of AKI patients receiving HVPD. The application of 18 mg/kg vancomycin every 48 - 72 hours in AKI patients undergoing HVPD was required to maintain therapeutic concentrations.

Six-Month Overnight Intraperitoneal Amino-Acid Infusion in Continuous Ambulatory Peritoneal Dialysis (CAPO) Patients-No Effect on Nutritional Status

1990 ◽  
Vol 10 (1) ◽  
pp. 79-84 ◽  
Author(s):  
Nicholas V. Dombros ◽  
Krystyne Prutis ◽  
Mathew Tong ◽  
G. Harvey Anderson ◽  
Joan Harrison ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Nutritional Status ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Protein Intake ◽  
Statistical Significance ◽  
Caloric Intake ◽  
Skinfold Thickness ◽  
Amino Acid Infusion ◽  
Long Term Effect ◽  
Total Body

The long-term effect of an AA solution based on Tra-vasol®, a solution for total parenteral nutrition, given in-traperitoneally over a 6-month period was studied in 5 patients 22 to 75 years old, having been on continuous ambulatory peritoneal dialysis (CAPD) for 3 to 57 months. A low oral protein intake (<0.8 g/kg bw /day) and/or a low serum albumin «35 g/L) were used as inclusion criteria. Two liters of 1% AA solution were infused overnight, while a glucose Dianeal® was used for the other exchanges. During the study, BUN increased from 22.04 mM/L to 28.06 mM/L the first month and remained at these levels, indicating the increased protein intake. However, average oral total energy and protein intake, body weight (bw), serum creatinine, cholesterol, triglycerides, total proteins, albumin, transferrin, skinfold thickness, total body potassium, and plasma AA levels remained basically unchanged. The average total body nitrogen decreased from 1.746 to 1.554 Kg, but this decrease did not reach statistical significance (p > 0.05). We conclude that intraperitoneal overnight administration of 2 L of 1% AA based on Travasol® over 6 months did not improve the nutritional status of CAPD patients. This ineffectiveness might be due to the AA composition of the solution, the timing of administration, or to a low caloric intake and/or that our patients were not severely malnourished.

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