Relationships among pulmonary capillary wedge pressure, dry weight and natriuretic peptide in patients undergoing hemodialysis: a three-dimensional speckle tracking echocardiography study

Sato, Hidemaro; Kawasaki, Masanori; Tanaka, Ryuhei; Yoshizane, Takashi; Ono, Katsushige; Tadokoro, Mitsunobu; Yano, Yumihiko; Kondou, Takehito; Kariya, Takehiko; Nagata, Kijun; Gotoh, Kohshi; Shibata, Shigeki; Noda, Toshiyuki; Watanabe, Soichi

doi:10.1007/s12574-020-00461-1

Cited by 2 publications

(1 citation statement)

References 27 publications

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“…There is no standard measure of dry weight, so it is difficult to ascertain the adequacy of fluid removal for individual patients [8]. Several different techniques, including inferior diameter, natriuretic peptide, and bioimpedance, were used to derive a more standard method of assessing dry weight [9][10][11][12]; however, no single method has 2 of 14 emerged as a gold standard, so nephrologists need to frequently adjust the patient's dry weight on the basis of interdialytic weight gain and intradialytic hemodynamic changes [13]. In addition, the abdominal peritoneum is used as a semipermeable dialysis membrane in peritoneal dialysis (PD) to provide 24 h of continuous toxin and fluid removal.…”

Section: Introductionmentioning

confidence: 99%

Peritoneal-Membrane Characteristics and Hypervolemia Management in Peritoneal Dialysis: A Randomized Control Trial

Chuang

Lin

et al. 2021

Membranes

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Excessive bodily-fluid retention is the major cause of hypertension and congestive heart failure in patients with end-stage renal disease. Compared to hemodialysis, peritoneal dialysis (PD) uses the abdominal peritoneum as a semipermeable dialysis membrane, providing continuous therapy as natural kidneys, and having fewer hemodynamic changes. One major challenge of PD treatment is to determine the dry weight, especially considering that the speed of small solutes and fluid across the peritoneal membrane varies among individuals; considerable between-patient variability is expected in both solute transportation and ultrafiltration capacity. This study explores the influence of peritoneal-membrane characteristics in the hydration status in patients on PD. A randomized control trial compares the bioimpedance-assessed dry weight with clinical judgment alone. A high peritoneal membrane D/P ratio was associated with the extracellular/total body water ratio, dialysate protein loss, and poor nutritional status in patients on PD. After a six-month intervention, patients with monthly bioimpedance analysis (BIA) assistance had better fluid (−1.2 ± 0.4 vs. 0.1 ± 0.4 kg, p = 0.014) and blood-pressure (124.7 ± 2.7 vs. 136.8 ± 2.8 mmHg, p < 0.001) control; however, hydration status and blood pressure returned to the baseline after we prolonged BIA assistance to a 3-month interval. The dry-weight reduction process had no negative effect on residual renal function or peritoneal-membrane function. We concluded that peritoneal-membrane characteristics affect fluid and nutritional status in patients on PD, and BIA is a helpful objective technique for fluid assessment for PD.

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