The Effect of Racial Origin on Total Body Water Volume in Peritoneal Dialysis Patients

Abstract

SummaryBackground and objectives Peritoneal dialysis adequacy is typically assessed by urea clearance corrected for total body water (TBW) on the basis of anthropomorphic equations, which do not readily take into account changes in body composition, which may vary between ethnic groups. To determine whether ethnicity could affect estimates of peritoneal dialysis adequacy, we compared TBW estimated by anthropomorphic equations and that measured by multifrequency bioimpedance spectroscopy. Design, setting, participants, & measurementsWe calculated TBW in 600 healthy adult peritoneal dialysis outpatient attending two tertiary university hospitals serving an inner-city multiethnic population who had TBW measured by multifrequency bioimpedance spectroscopy performed.Results 600 adult peritoneal dialysis patients were studied: mean age, 56.7 Ϯ 0.6 years; 54.2% men; 29.7% diabetic; mean body mass index, 26.1 Ϯ 0.2; 47.3% Caucasian; 29.2% South Asian; 12.8% African/Afro-Caribbean. Total body water was calculated using several anthropomorphic equations and was higher than that calculated MEASURED BY MF-BIS for all ethnic groups, apart from African/Afro-Caribbeans, with the greatest difference between Watson calculated TBW and multifrequency bioelectrical impedance spectroscopy 12.3 Ϯ 0.6% for the South Asians, 9.0 Ϯ 2.6% for Far Eastern Asians, 2.8 Ϯ 0.6% Caucasians, and Ϫ0.2 Ϯ 1.5% for African/Afro-Caribbeans. ConclusionsIn this United Kingdom-based multiethnic population, body composition differed particularly for the South Asian patients compared with Caucasians and African/Afro-Caribbeans. Overestimation of TBW by anthropomorphic-based equations would lead to a lower calculation of Kt/V urea , which may lead to changes in peritoneal dialysis prescription to achieve clinical standard targets and also affect studies examining the relationship between Kt/V and survival.

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

“…We showed that albumin was related to fluid status. Previous studies have revealed that there is a negative correlation between albumin and OH (Davison et al 2009;Davenport et al 2011a;Van Biesen et al 2011). Lower albumin levels may result from extracellular dilution in OH status.…”

Scaling Hemodialysis Target Dose to Reflect Body Surface Area, Metabolic Activity, and Protein Catabolic Rate: A Prospective, Cross-sectional Study

“…Patients of South Asian ethnicity are also found to be at risk of under-dialysis if REE or TEE were considered as scaling parameters. Bioimpedance studies have suggested differences in body composition, particularly muscle mass, in South Asians compared to Whites and Blacks 26 . However, these subgroup differences are likely to be secondary to the differences in body weight, and physical activity levels rather than a direct effect of these characteristics on metabolic needs.…”

Associations of Proteinuria, Fluid Volume Imbalance, and Body Mass Index with Circadian Ambulatory Blood Pressure in Chronic Kidney Disease Patients

“…Further, the TBW BIA /TBW Watson ratio was less than 1.0 in all the patients, suggesting that TBW Watson may have been overestimated in the general Japanese population. A previous study reported differences in TBW Watson across individuals depending on race [31]. If the TBW BIA /TBW Watson ratio is applied more practically, a precise value of TBW in the Japanese population can be estimated, so that a reference range for the TBW BIA /TBW Watson ratio can be established in the future by using catamnestic data.…”