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Peritoneal protein clearance, fluid overload, and cardiovascular events in patients undergoing peritoneal dialysis: a

Hongjian Ye1,2, Ruihua Liu1,2, Peiyi Cao1,2

  • 1Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

Renal Failure
|February 18, 2025
PubMed

Insights

Higher peritoneal protein clearance (PPCl) in peritoneal dialysis (PD) patients is linked to fluid overload and a greater risk of cardiovascular events. This study clarifies the independent association between PPCl and adverse outcomes in PD patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Clinical Research

Background:

  • The link between peritoneal protein clearance (PPCl), fluid overload, and cardiovascular (CV) events in peritoneal dialysis (PD) patients requires clarification.
  • Understanding these associations is crucial for managing PD patient health and reducing CV risk.

Purpose of the Study:

  • To investigate the relationship between higher PPCl and fluid overload in PD patients.
  • To examine the independent association of PPCl and fluid overload with the risk of CV events in PD patients.

Main Methods:

  • A prospective cohort study enrolled 351 PD patients from a single center.
  • PPCl was calculated using daily dialysate protein loss corrected for serum albumin.
  • Fluid overload was defined by extracellular water/total body water ratio (≥0.400) via bioelectrical impedance analysis (BIA); CV events were the primary outcome.

Main Results:

  • An increase in PPCl was independently associated with a higher risk of fluid overload (OR: 1.27).
  • Both fluid overload (SHR: 1.70) and increased PPCl (SHR: 1.09) were independently linked to an increased risk of CV events.
  • PPCl remained a significant independent predictor of CV events even when fluid overload was considered.

Conclusions:

  • Higher PPCl is independently associated with fluid overload in PD patients.
  • Elevated PPCl is an independent risk factor for cardiovascular events in PD patients.
  • These findings highlight the importance of monitoring PPCl in PD patients to mitigate CV risk.
Abstract

Keywords:
ECW/TBW ratioPeritoneal dialysiscardiovascular eventfluid overloadperitoneal protein clearance

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