Background Patients receiving peritoneal dialysis experience a high technique failure rate and are often overhydrated. We examined whether an increased extracellular fluid volume (VECF) as a proportion of the total body water (VTBW) predicted technique survival (TS) in a prevalent patient cohort. Methods The VECF and VTBW were estimated by multiple-frequency bioelectric impedance in 59 prevalent peritoneal dialysis patients (median time on dialysis 14 months). Demographic, biochemical (albumin, C-reactive protein, and ferritin), and anthropometric data, forearm muscle strength, nutritional score by three-point Subjective Global Assessment, residual renal function, dialysate-to-plasma (D/P) creatinine ratio, total weekly Kt/V urea, total creatinine clearance, normalized protein equivalent of nitrogen appearance, and midarm muscle circumference were also assessed. Technique survival was determined at 3 years, and significant predictors of TS were sought. Results In patient groups defined by falling above or below the median value for each parameter, only residual renal function ( p = 0.002), 24-hour ultrafiltrate volume ( p = 0.02), and VECF / VTBW ratio ( p = 0.05) were significant predictors of TS. Subjects with a higher than median VECF / VTBW ratio had a 3-year TS of 46%, compared to 78% in subjects with a lower than median value. In multivariate analysis, systolic blood pressure and VECF / VTBW ratio (both p < 0.05) were significant predictors of TS. C-reactive protein approached significance. Conclusion Increased ratio of extracellular fluid volume to total body water is associated with decreased TS in peritoneal dialysis.
Total body water reduction in subjects with chronic kidney disease on peritoneal dialysis is associated with a better hypertension control
