Enrollment fluid status is independently associated with long-term survival of peritoneal dialysis patients

Area of Science:

• Nephrology
• Clinical Medicine
• Physiology

Background:

• Fluid overload is a frequent complication in patients undergoing peritoneal dialysis (PD).
• The prognostic value of initial fluid status in long-term PD patients requires further investigation.
• Understanding fluid status is critical for improving PD patient outcomes.

Purpose of the Study:

• To investigate the prognostic importance of enrollment fluid status on the long-term survival of PD patients.
• To determine if extracellular water indexed to body surface area (ECW-BSA) predicts mortality in PD patients.

Main Methods:

• Fifty-three PD patients were enrolled, with demographic, clinical, and biochemical data collected.
• Bioelectrical impedance analysis (BIA) assessed fluid status, including extracellular water (ECW), intracellular water (ICW), and total body water (TBW), corrected for body surface area (BSA).
• Patients were followed for long-term survival, with statistical analyses including correlation, Kaplan-Meier, and multivariate Cox regression.

Main Results:

• Enrollment ECW-BSA correlated negatively with albumin and positively with the ICW/ECW ratio, and negatively with the ECW/TBW ratio.
• Patients who survived had significantly lower enrollment ECW-BSA compared to non-survivors (8.29 L/m2 vs. 9.91 L/m2, p = 0.001).
• Enrollment ECW-BSA independently predicted mortality (relative risk: 1.50; p = 0.03) after adjusting for covariates.

Conclusions:

• Enrollment extracellular water indexed to body surface area (ECW-BSA) is a significant independent predictor of long-term survival in peritoneal dialysis patients.
• ECW-BSA serves as a valuable prognostic marker for mortality risk in PD patients.
• Monitoring and managing fluid status, particularly ECW-BSA, is crucial for improving outcomes in PD.