Overhydration Negatively Affects Quality of Life in Peritoneal Dialysis Patients: Evidence from a Prospective Observational Study

Abstract

Backgound: This study evaluated whether the hydration status affected health-related quality of life (HRQOL) during 12 months in peritoneal dialysis (PD) patients.Methods: The hydration status and the HRQOL were examined at baseline and after 12 months using a bioimpedance spectroscopy and Kidney Disease Quality of Life-Short Form, respectively in PD patients. Four hundred eighty-one patients were included and divided according to the baseline overhydration (OH) value; normohydration group (NH group, -2L≤ OH ≤+2L, n=266) and overhydration group (OH group, OH >+2L, n=215). Baseline HRQOL scores were compared between the two groups. The subjects were re-stratified into quartiles according to the OH difference (OH value at baseline - OH value at 12 months; <-1, -1 - -0.1, -0.1 - +1, and ≥+1L). The relations of OH difference with HRQOL scores at 12 months and the association of OH difference with the HRQOL score difference (HRQOL score at baseline - HRQOL score at 12 months) were assessed.Results: The OH group showed significantly lower baseline physical and mental health scores (PCS and MCS), and kidney disease component scores (KDCS) compared with the NH group (all, P<0.01). At 12 months, the adjusted PCS, MCS, and KDCS significantly increased as the OH difference quartiles increased (P<0.001, P=0.002, P<0.001, respectively). In multivariate analysis, the OH difference was independently associated with higher PCS (β = 2.04, P< .001), MCS (β=1.02, P=0.002), and KDCS (β=1.06, P<0.001) at 12 months. The OH difference was independently associated with the PCS difference (β = -1.81, P<0.001), MCS difference (β=-0.92, P=0.01), and KDCS difference (β=-0.90, P=0.001).Conclusion: The hydration status was associated with HRQOL and increased hydration status negatively affected HRQOL after 12 months in PD patients.

Clinical usefulness of bioimpedance analysis for assessing volume status in patients receiving maintenance dialysis

“…O’Lone et al [ 54 ] showed that the OH/ECW ratio was an independent predictor of mortality in 529 patients undergoing PD, but the ECW/TBW ratio was not associated with increased mortality. Yoon et al [ 55 ] reported that OH was associated with lower health-related quality of life in 481 patients undergoing PD.…”

Asymptomatic fluid overload predicts survival and cardiovascular event in incident Chinese peritoneal dialysis patients

“…Fluid overload is common among patients on peritoneal dialysis (PD), and it represents an important non-traditional risk factor of cardiovascular diseases in this group of patients [ 1 ]. Previous studies showed that clinically overt fluid overload is associated with decrease in patient and technique survival [ 2 , 3 ], excess peritonitis rate (with enteric organisms) [ 4 ], increase in left ventricular mass [ 5 ] and impaired quality of life [ 6 ]. However, assessment of volume status is frequently unreliable by traditional methods.…”

Risk, Severity, and Predictors of Obstructive Sleep Apnea in Hemodialysis and Peritoneal Dialysis Patients

“…Fluid overload is more prevalent in PD patients than in HD patients [ 38 ]. In PD patients, ultrafiltration failure remains a major cause of treatment failure [ 39 ], and fluid overload is an independent predictor of mortality and negatively impacts life quality [ 40 , 41 ]. Increased vascular volume in the neck (i.e., rostral fluid shifts) may promote upper airway obstruction in OSA patients [ 26 ].…”