engleski

Comparison of Two Methods for Estimating Volume Status in Incident Peritoneal Dialysis Patients – David vs. Goliath

Introduction. Clinical assessment (CA) is the most commonly used method for the evaluation of volume status in peritoneal dialysis (PD) patients despite its subjectivity. Multiple- frequency bioelectrical impedance analysis (MF- BIA) is objective, accurate, and quick, proving to be a promising technique for measuring volume status. The aim of this study was to assess volume status in PD patients using CA and MF-BIA and to compare results. Methods. Incident PD patients were prospectively analyzed between January 1, 2014 and January 1, 2016 at the Clinical Hospital Center of Rijeka, Croatia. Volume status measurements were performed once a month for 6 consecutive months. The presence of symptoms and signs associated with hyper- or hypovolemia were detected by CA. Euvolemia was defined as a symptom-free state or up to 2 symptoms maximum. Patients lacking up to 1.2 L of volume or with up to 1.2 L in excess were considered euvolemic, as measured by MF-BIA. Results. A total of 45 PD patients were analyzed ; 51 % were men, 27% were diabetic, the mean age was 52 ± 26 years, and PD duration was 11.5 ± 6.5 months. In comparison to MF-BIA, CA showed a significant difference in detected hypervolemia between baseline and follow-up (p=0.708 vs. p=0.01, respectively) and among all measurements (p<0.01). Contrary to CA, volume status measured by MF-BIA correlated significantly with systolic and dyastolic blood pressure (R=0.29 ; p≤0.01 and R=0.26 ; p≤0.01, respectively). CA showed low sensitivity (0.24) and high specificity (0.92) in detecting hypervolemia. Conclusions. MF-BIA is an effective, objective, and safe method for assessing volume status in PD patients. Longitudinal monitoring of body composition changes - including hydration state - leading to adequate therapeutic intervention is a promising and potential application of MF-BIA along with CA.

volume status ; peritoneal dialysis ; clinical assessment ; multiple-frequency bioelectrical impedance analysis

nije evidentirano