Residual Urinary Volume Is a Predictor of Overhydration in Patients on Peritoneal Dialysis

Jung, Eul Sik; Sung, Ji Yoon; Han, Song Yi; Kim, Ae Jin; Ro, Han; Jung, Ji Yong; Lee, Hyun Hee; Chung, Wookyung; Chang, Jae Hyun

doi:10.1620/tjem.233.295

Cited by 4 publications

(5 citation statements)

References 29 publications

(33 reference statements)

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“…One potential explanation is that UV has a stronger association with volume status. Several studies also revealed that extracellular volume expansion was associated with UV in patients on dialysis (27,32). Recently, overhydration measured by the Body Composition Monitor significantly correlated with UV but did not correlate with GFR-24U in patients on PD (27), supporting our observation.…”

Section: Discussionsupporting

confidence: 84%

“…Several studies also revealed that extracellular volume expansion was associated with UV in patients on dialysis (27,32). Recently, overhydration measured by the Body Composition Monitor significantly correlated with UV but did not correlate with GFR-24U in patients on PD (27), supporting our observation. In patients on HD, UV was the largest in patients with low interdialytic weight gain (interdialytic weight gain/dry weight ,1.0%), despite comparable GFR-24U (33).…”

Section: Discussionsupporting

confidence: 84%

“…A recent study showed that overhydration measured by bioelectric impedance analyses was significantly associated with UV but was not associated with GFR-24U in patients on PD (27). On the basis of this result, we hypothesized that UV may be more closely associated with prognosis than other indices because of its relevant association with volume status.…”

Section: Introductionmentioning

confidence: 83%

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Prognostic Value of Residual Urine Volume, GFR by 24-hour Urine Collection, and eGFR in Patients Receiving Dialysis

Lee

Park

et al. 2017

CJASN

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Background and objectives Residual kidney function can be assessed by simply measuring urine volume, calculating GFR using 24-hour urine collection, or estimating GFR using the proposed equation (eGFR). We aimed to investigate the relative prognostic value of these residual kidney function parameters in patients on dialysis.Design, setting, participants, & measurements Using the database from a nationwide prospective cohort study, we compared differential implications of the residual kidney function indices in 1946 patients on dialysis at 36 dialysis centers in Korea between August 1, 2008 and December 31, 2014. Residual GFR calculated using 24-hour urine collection was determined by an average of renal urea and creatinine clearance on the basis of 24-hour urine collection. eGFR-urea, creatinine and eGFR b 2 -microglobulin were calculated from the equations using serum urea and creatinine and b 2 -microglobulin, respectively. The primary outcome was all-cause death.Results During a mean follow-up of 42 months, 385 (19.8%) patients died. In multivariable Cox analyses, residual urine volume (hazard ratio, 0.96 per 0.1-L/d higher volume; 95% confidence interval, 0.94 to 0.98) and GFR calculated using 24-hour urine collection (hazard ratio, 0.98; 95% confidence interval, 0.95 to 0.99) were independently associated with all-cause mortality. In 1640 patients who had eGFR b 2 -microglobulin data, eGFR b 2 -microglobulin (hazard ratio, 0.98; 95% confidence interval, 0.96 to 0.99) was also significantly associated with all-cause mortality as well as residual urine volume (hazard ratio, 0.96 per 0.1-L/d higher volume; 95% confidence interval, 0.94 to 0.98) and GFR calculated using 24-hour urine collection (hazard ratio, 0.97; 95% confidence interval, 0.95 to 0.99). When each residual kidney function index was added to the base model, only urine volume improved the predictability for all-cause mortality (net reclassification index =0.11, P=0.01; integrated discrimination improvement =0.01, P=0.01).Conclusions Higher residual urine volume was significantly associated with a lower risk of death and exhibited a stronger association with mortality than GFR calculated using 24-hour urine collection and eGFR-urea, creatinine. These results suggest that determining residual urine volume may be beneficial to predict patient survival in patients on dialysis.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 83%

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Prognostic Value of Residual Urine Volume, GFR by 24-hour Urine Collection, and eGFR in Patients Receiving Dialysis

Lee

Park

et al. 2017

CJASN

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“…20,21 It is likely that residual urinary volume is the main predictor of overhydration in patients on PD. 22 Moreover, our study demonstrated a significant correlation between residual urine output and hydration status (r = −0.36; p = 0.004).…”

Section: Discussionsupporting

confidence: 50%

The association of serum soluble Klotho levels and residual diuresis and overhydration in peritoneal dialysis patients

Sikorska¹,

Pawlaczyk²,

Baum³

et al. 2019

Adv Clin Exp Med

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Background. Klotho, originally identified as an anti-aging factor, is a transmembrane protein expressed in the kidney. It has been reported that Klotho deficiency could be associated with a loss of residual renal function and cardiovascular complications in peritoneal dialysis (PD) patients. Objectives.The main aim of the study was to evaluate whether serum levels of Klotho correlate with residual diuresis and hydration status in PD patients.Material and methods. The cross-sectional study involved 57 PD patients ≥18 years of age who had been on PD ≥ 3 months. Serum Klotho was measured using high-sensitivity enzyme-linked immunosorbent assay (ELISA). Hydration status was assessed with bioimpedance analysis (BIA).Results. Serum levels of soluble Klotho ranged from 100 pg/mL to 700 pg/mL. The patients were divided into 2 subgroups, with Klotho levels below and above the median (260 pg/mL). The data revealed a tendency for lower residual diuresis (1.3 ±1.0 L vs 1.8 ±0.8 L; p = 0.055) in patients with lower levels of Klotho in serum. Serum Klotho correlated negatively with overhydration according to BIA (r = −0.27; p = 0.044) and positively with residual diuresis (r = 0.26; p = 0.045). Conclusions.Soluble Klotho correlates inversely with hydration status in BIA. Residual urine output, but not dialysis parameters, could be associated with the levels of serum soluble Klotho in PD patients.

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“…All of our subjects were non-anuric, with residual urine volume > 500 mL/day at baseline. One recent report (27) found that residual urine volume is the strongest predictor of volume overload in PD. Most of the subjects in both groups were taking diuretics prior to the study.…”

Section: Discussionmentioning

confidence: 99%

Does Routine Bioimpedance-Guided Fluid Management Provide Additional Benefit to Non-Anuric Peritoneal Dialysis Patients? Results from Compass Clinical Trial

Baek

Joo

et al. 2017

Perit Dial Int

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Residual Urinary Volume Is a Predictor of Overhydration in Patients on Peritoneal Dialysis

Cited by 4 publications

References 29 publications

Prognostic Value of Residual Urine Volume, GFR by 24-hour Urine Collection, and eGFR in Patients Receiving Dialysis

Prognostic Value of Residual Urine Volume, GFR by 24-hour Urine Collection, and eGFR in Patients Receiving Dialysis

The association of serum soluble Klotho levels and residual diuresis and overhydration in peritoneal dialysis patients

Does Routine Bioimpedance-Guided Fluid Management Provide Additional Benefit to Non-Anuric Peritoneal Dialysis Patients? Results from Compass Clinical Trial

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