The Effect of Fluid Overload on Clinical Outcome in Southern Chinese Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

Guo, Qunying; Lin, Jianxiong; Li, Jianying; Chen, Yi; Mao, Haiping; Yang, Xiao; Yu, Xueqing

doi:10.3747/pdi.2014.00008

Cited by 71 publications

(85 citation statements)

References 37 publications

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“…The characteristics of patients in the 8 included studies [4,14,[33][34][35][36][37][38], which consisted of a total of 1,989 PD patients, are listed in Table 1. There were 4 studies conducted in Asia (2 in China [14,38], and 2 in Korea [33,34]), 3 studies in Europe (2 in the United Kingdom [4,36], and 1 in Switzerland [35]), and 1 study in the United States [37].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…There were 4 studies conducted in Asia (2 in China [14,38], and 2 in Korea [33,34]), 3 studies in Europe (2 in the United Kingdom [4,36], and 1 in Switzerland [35]), and 1 study in the United States [37]. The number of patients varied from 53 [37] to 631 [34], and the mean follow-up time ranged from 1.0 year [34] to 7.5 years [33].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…When considering risk factors for mortality and dialysis inadequacy among PD patients, recent focus has shifted from small-molecule clearance to fluid overload [9]. Fluid overload is considered a contributor to mortality and technique failure among PD patients due to its association with complications such as hypertension [10], heart failure [11], increased cardiovascular event [12], arterial stiffness [13] and peritonitis [14], as well as inflammation [15], malnutrition [15,16] and loss of residual renal function [17,18]. However, it remains unclear whether overhydration is an independent predictor of PD clinical outcomes or whether it just reflects underlying comorbidities such as hypertension and cardiac dysfunction.…”

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confidence: 99%

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The Effect of Overhydration on Mortality and Technique Failure Among Peritoneal Dialysis Patients: A Systematic Review and Meta-Analysis

et al. 2018

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Background: Overhydration is common among peritoneal dialysis (PD) patients and can affect PD-related outcomes. This paper aims to systematically investigate whether bioimpedance-assessed overhydration is a predictor for mortality and technique failure in PD patients. Methods: We conducted a systematic review and meta-analysis of cohort studies on overhydration and prognosis in PD patients, strictly complying with the Preferred Reporting Items for Systematical Reviews and Meta-analyses. Results: Eight articles met the selection criteria and 5 studies were included in the meta-analysis. Meta-analyses-revealed overhydration, defined as a high ratio of extracellular water/total body water (ECW/TBW), was significantly associated with higher risk for all-cause mortality and technique failure. Other higher dichotomized overhydration indicators and continuous hydration variables all indicated overhydration as a significant risk factor for all-cause mortality. Conclusion: Overhydration, defined by a higher ratio of ECW/TBW, might be an independent predictor for all-cause mortality and technique failure among PD patients. However, more studies are needed to confirm this conclusion. Video Journal Club ‘Cappuccino with Claudio Ronco’ at https://www.karger.com/Journal/ArticleNews/223997?sponsor=52

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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confidence: 99%

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The Effect of Overhydration on Mortality and Technique Failure Among Peritoneal Dialysis Patients: A Systematic Review and Meta-Analysis

et al. 2018

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“…The highest mortality risk was in those with fluid overload and systolic BP < 130 mmHg at baseline (HR 1.51, 1.38-1.65, p < 0.001) and at 1 year (HR 1.94, 1.68-2.23, p < 0.001) [119]. Fluid overload also independently predicted all-cause mortality (HR 12.98, 1.06-168.23, p = 0.042) and a trend of increased CVD mortality (log-rank test 2.90, p = 0.089) in a trial of 307 PD patients [120]. Interestingly, a multi-centre RCT of 308 patients found that bio-impedance did not appear to improve clinical management of fluid status in PD patients [121].…”

Section: Chronic Volume Overloadmentioning

confidence: 93%

Cardiovascular Disease in Dialysis Patients

Jegatheesan¹,

Yang²,

Krishnasamy³

et al. 2018

Aspects in Dialysis

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Cardiovascular disease (CVD) is highly prevalent in the dialysis population, affecting up to 60% of cohorts. Cardiovascular mortality rates are reported to be ~14 per 100 patient-years, which are 10-to 20-fold greater than those of age-and gender-matched controls. CVD is the primary cause of death in up to 40% of dialysis patients in Australia, New Zealand and the United States. Dialysis patients endure a greater burden of both traditional risk factors for CVD and risk factors related to loss of kidney function that may account for the higher CVD morbidity and mortality. Many cardiology guidelines include chronic kidney disease (CKD) and end-stage kidney disease (ESKD) as coronary heart disease (CHD) risk equivalents. It is therefore important for clinicians to both recognise and optimise the cardiovascular health of patients receiving maintenance dialysis. This chapter will focus on risk factor modification, screening and prevention of CVD in dialysis patients.

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“…Measured glomerular filtration rate (mGFR) was calculated from 24-h urine collections and indexed for the body surface area. CVD was defined as a history of myocardial infarction, angina, congestive heart failure, cerebrovascular event, and peripheral vascular disease [14]. The comorbidity score was determined according to the Charlson Comorbidity Index [15].…”

Section: Data Collectionmentioning

confidence: 99%

Association of Serum Uric Acid with Arterial Stiffness in Peritoneal Dialysis Patients

Liu

et al. 2018

Kidney Blood Press Res

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Background/Aims: Serum uric acid (SUA) has been proposed as a mediator associated with increased cardiovascular risk and arterial stiffness. However, evidence on the association between SUA and arterial stiffness in peritoneal dialysis (PD) patients is lacking. The aim of this study was to examine the relationship between SUA and arterial stiffness in PD patients. Methods: The patients who performed vascular profiler test from January 1, 2014 to October 31, 2016, and with SUA values were enrolled. Arterial stiffness was evaluated by brachial-ankle pulse wave velocity (baPWV). The relationship between SUA and baPWV was tested by multiple linear regression models. Results: Of 645 PD patients, mean SUA was 6.80 (±1.29) mg/dL, mean baPWV was 1713 (±505) cm/s. In fully adjusted linear regression models, higher SUA was significantly associated with higher baPWV in young [standardized coefficients (β), 0.085; 95% confidence interval (95% CI), 0.013 to 0.130; P=0.02] but not in elderly (β, -0.194; 95% CI, -0.774 to 0.093; P=0.1) PD patients. In gender-stratified models of young patients, there was a significant association between SUA and baPWV in male (β, 0.115; 95% CI, 0.015 to 0.182; P=0.02) but not in female. Male in the highest gender-specific SUA quartile had a higher baPWV than those in the lowest quartile (β, 0.132; 95% CI, 0.011 to 0.209; P=0.03). This gender difference was reversed when selecting male patients with lower SUA levels (quartile 1 and 2) and female patients with higher SUA levels (quartile 3 and 4). Conclusion: SUA was positively associated with baPWV in young PD patients, and this association was significant in males but not in females, which is possibly explained by the higher SUA level in males than in females.

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The Effect of Fluid Overload on Clinical Outcome in Southern Chinese Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

Cited by 71 publications

References 37 publications

The Effect of Overhydration on Mortality and Technique Failure Among Peritoneal Dialysis Patients: A Systematic Review and Meta-Analysis

The Effect of Overhydration on Mortality and Technique Failure Among Peritoneal Dialysis Patients: A Systematic Review and Meta-Analysis

Cardiovascular Disease in Dialysis Patients

Association of Serum Uric Acid with Arterial Stiffness in Peritoneal Dialysis Patients

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