Inflammation is associated to volume status in peritoneal dialysis patients

Abstract

Aim: The aim of this study is to investigate whether there is a relationship between inflammation and volume status in patients underwent peritoneal dialysis (PD). Patients and method: This cross-sectional study included 159 PD patients. The median duration of PD was 17 (range, 1-151) months. All patients were examined using bioelectrical impedance analysis to estimate the ratio of extracellular water to total body water (ECW/TBW), which was used to assess their volume status. The patients were categorized as having one of the following three volume statuses: hypervolemic (above +2 SD from the mean, which was obtained from healthy controls), normovolemic (between +2 SD and À2 SD), or hypovolemic (below À2 SD from the mean). Five patients with hypovolemia were excluded from the study. Fifty-six patients were hypervolemic whereas 98 patients were euvolemic. High-sensitive C-reactive protein (hs-CRP) levels were measured to evaluate inflammation in all patients. Results: hs-CRP value levels were significantly higher in hypervolemic patients compared with euvolemic patients [7.1 (3.1-44.0) mg/L vs. 4.3 (3.1-39.6), p: 0.015, respectively]. Left ventricular hypertrophy was more frequent in hypervolemic patients compared with euvolemic patients (53.6% vs. 30.6%, p: 0.004, respectively). ECW/TBW ratio positively correlated with hs-CRP (r: 0.166, p: 0.039). Gender, hs-CRP, and residual Kt/V urea were found to be independent risk factors for hypervolemia in multivariate analysis. Conclusion: Inflammation is associated with hypervolemia in PD patients. Residual renal functions play an important role to maintain euvolemia in PD patients.

From MIA to FIFA: The vicious matrix of frailty, inflammation, fluid overload and atherosclerosis in peritoneal dialysis

“…In PD patients, the same pattern of correlation has been reported 108,109,116,117 . For example, CRP levels were significantly increased in hypervolemic PD patients, and the severity of fluid overload 117,118 . Similarly, serum IL‐6 levels correlated with overhydration and NT‐pro‐BNP levels in PD patients 119 …”

“…108,109,116,117 For example, CRP levels were significantly increased in hypervolemic PD patients, and the severity of fluid overload. 117,118 Similarly, serum IL-6 levels correlated with overhydration and NT-pro-BNP levels in PD patients. 119 The pathogenic link between fluid overload and inflammation is an active area of research.…”

Status of hydration assessed by bioelectrical impedance analysis: a valuable predictive factor for radiation-induced oral mucositis in head and neck cancer patients

“…It is well known, inter-alia on the basis of many studies with dialyzed subjects, that there is a strict correlation between the inflammation involving TNFα, IL-1β, IL-6 and MMPs and hydration changes [9][10][11]. In a cross-sectional study, including 159 patients subjected to peritoneal dialysis, Unal et al [19] demonstrated that in hypervolemic patients compared with euvolemic patients, hs-CRP value levels were significantly higher. The ECW/TBW ratio positively correlated with hs-CRP.…”

Association of bioimpedance analysis parameters trajectories with clinical outcomes in neurocritical patients

“…Notably, through trajectory modeling and correlation analysis, we observed that the high ECW/TBW trajectory group showed a slow and sustained elevated course of change in the trend from 1 to 7 days of admission. The sustained increase in ECW/TBW may reflect a loss of muscle mass [ 24 ]. Meanwhile, a study by Unal A [ 24 ]et al noted that the ECW/TBW ratio was positively correlated with the inflammatory index hypersensitivity C-reactive protein.…”

“…In the intensive care unit (ICU) setting, PA and ECW/TBW are associated with worse clinical outcomes such as mortality rate and length of ICU stay [ [20] , [21] , [22] ]. In addition, PA and ECW/TBW are also considered to be closely related to nutritional and inflammatory status, serving as comprehensive indicators that can simultaneously reflect both states [ 23 , 24 ]. However, previous studies have mostly focused on the relationship between the measurement values of these indicators at a given moment and prognosis, failing to continuously measure and dynamically assess changes in clinical status.…”