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Fluid Overload in Peritoneal Dialysis Patients.

Yong-Lim Kim1, Wim Van Biesen2

  • 1Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.

Seminars in Nephrology
|February 4, 2017
PubMed
Summary

Effective volume management in peritoneal dialysis is crucial for patient outcomes. Strategies include monitoring fluid status, salt restriction, diuretics, and adjusting dwell times based on transport, while glycaemia control prevents thirst.

Keywords:
bio-impedance, cardiac failureperitoneal dialysisvolume overload

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Area of Science:

  • Nephrology
  • Peritoneal Dialysis

Background:

  • Volume management is critical in peritoneal dialysis (PD) patients.
  • Both volume overload and dehydration negatively impact patient outcomes.
  • Accurate assessment requires understanding different fluid compartments and cardiac function.

Purpose of the Study:

  • To review key considerations for optimizing volume status in peritoneal dialysis patients.
  • To highlight strategies for achieving and maintaining euvolemia.

Main Methods:

  • Review of current literature and clinical practices in PD volume management.
  • Discussion of various assessment techniques and their limitations.
  • Analysis of interventions such as dietary modifications, pharmacological agents, and dialysis prescription adjustments.

Main Results:

  • Different methods assess distinct fluid compartments (intracellular, extracellular, circulating).
  • Cardiac function significantly influences volume assessment.
  • Salt restriction and diuretics can maintain euvolemia without hypertonic solutions.
  • Glycaemia monitoring is essential to prevent thirst.
  • Dialysis dwell length should be tailored to patient transport status (short for fast, long for slow transporters).

Conclusions:

  • Optimizing volume status in PD requires a multifaceted approach.
  • Individualized strategies considering fluid compartments, cardiac function, and transport status are essential.
  • The impact of biocompatible solutions on volume control requires further investigation.