Abstract: TH-OR095

Quasi-Continuous Monitoring of intraperitoneal Volume Using Segmental Bioimpedance in Peritoneal Dialysis Patients

Session Information

  • Peritoneal Dialysis
    November 02, 2017 | Location: Room 290, Morial Convention Center
    Abstract Time: 05:54 PM - 06:06 PM

Category: Dialysis

  • 608 Peritoneal Dialysis

Authors

  • Zhu, Fansan, Renal Research Institute, New York, New York, United States
  • Abbas, Samer R., Renal Research Institute, New York, New York, United States
  • Bologa, Roxana M., The Rogosin Institute, New York, New York, United States
  • Levin, Nathan W., Renal Research Institute, New York, New York, United States
  • Kotanko, Peter, Renal Research Institute, New York, New York, United States
Background

Ultrafiltration failure (UFF) is a frequent complication in peritoneal dialysis (PD) patients. The peritoneal equilibration test (PET) is the standard method for assessing peritoneal transport characteristics. However, dynamic changes in intraperitoneal volume (IPV) during the dwell cannot be determined by PET. The aim of this pilot study was to explore the feasibility of segmental bioimpedance analysis (SBIA) to quasi-continuously monitor IPV during dwell periods.

Methods

10 PD patients (7 females, age 59±8.8 years, weight 71.9±12 kg) with standard 4 hours PET using 2 L of 2.5 % dextrose PD solution were studied. Eight electrodes were placed as shown in Figure 1. At 5 kHz resistance (R5, Ohm) was measured from each pair of electrodes minute-by-minute with the Hydra 4200 device. During the PET IPV was calculated from the average R5 of the left and right sides of the abdomen (Zhu et al., Am J Kidney Dis, 42:167-172, 2003). This setting allowed us to follow the IPV time course and determine the maximum IPV from visual inspection of the recordings.

Results

In 9 patients the IPV measurements were technically successful; in 1 patient signal quality was poor. Figure 2 shows a typical IPV measurement. Average (SD) drain volume at 4 hours was 0.5±0.3 L by SBIA compared to weight loss (ΔWt) of 0.54±0.27 kg. Maximal IPV indicated by SBIA was 1.0±0.4 L. The difference between maximal IPV and drain volume was 0.5±0.4 L (95% confidence interval: 0.2 to 1.2; P<0.01 in a paired t-test) L. Maximal IPV was reached after a dwell time of 157±57 minutes (range 113 to 200 min).

Conclusion

This pilot study demonstrates the feasability of segmental bioimpedance to quasi-continuoously monitor IPV and to identify the time point of maximum IPV. These insights may help to optimize individual PD treatments and improve ultrafiltration efficiency. While these results are encouraging, additional validation studies, to automatically detect maximum IPV, and efforts to improve measurement convenience are required.

Fig1 and Fig2