Abstract: TH-PO864
Bioimpedance Monitoring and Blood Pressure in Peritoneal Dialysis Patients
Session Information
- Peritoneal Dialysis - I
November 02, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Dialysis
- 608 Peritoneal Dialysis
Authors
- Touam, Malik, Necker Hospital, Paris, France
- Cottereau, Marielle Lacombe, Necker Hospital, Paris, France
- Biroteau, Didier, Necker Hospital, Paris, France
- Joly, Dominique A, Assistance Publique Hôpitaux de Paris, Paris, France
Background
We used bioelectrical impedance analysis (BIA) to determine body composition parameters in peritoneal dialysis patients (PD), and we compared the relationships of hydratation status with home blood pressure (HBP) and office blood pressure (OBP).
Methods
This single center study enrolled all prevalent PD from 2014 to 2016. Patients recently started on PD (<3 m) or with recent peritonitis (<2 m) were not included. A bioimpedance monitor (BCM®, Fresenius Medical Care, Germany) was used to assess body composition. Demographic data, blood, 24-h dialysate and urine samples were collected. HBP and OBP measurements were collected the same day. Multivariate analysis was used to determine the relationship between HBP, OBP and extracellular fluid volume/total body water ratio (ECV/TBW). Potential cofounders included age, diabetes, Charlson comorbidity index, PD method (CAPD, APD), and residual renal function (RRF) were identified.
Results
63 PD were included (59.7 ± 13.4 y; average follow-up 13.6 ± 5.2 m). Systolic OBP (sOBP) and systolic HBP (sHBP) were correlated with ECV/TBW. It was a very strong relationship between sHBP and ECV/TBW (p<0.001) with sHBP, RRF and serum BNP being the independent predictors (table 1)
Conclusion
Systolic HBP, decreased RRF and serum BNP were major independent predictors of expanded ECV. In daily practice, expanded ECV should prompt to check home blood pressure.
Table 1. Predictors of % ECV/TBW
| Slope (95% CI) | p | |
| sHBP | -0.07 (-0.12 to -0.03) | <0.001 |
| RRF | -0.28 (-0.45 to -0.12) | <0.001 |
| Serum BNP | -0.23 (-0.36 to -0.09) | <0.001 |
| Hemoglobin | -0.04 (-0.12 to 0.03) | 0.250 |
| CRP | 0.10 (0.02 to 0.18) | 0.016 |
| Age at onset PD | -0.24 (-1.12 to 0.93) | 0.250 |
| Male gender | -0.77 (-2.41 to 0.88) | 0.357 |
| Diabetes | 1.49 (-0.13 to 3.12) | 0.072 |
| Charlson index | 0.40 (-1.32 to 2.12 ) | 0.649 |
| sOBP | 0.02 (-0.02 to 0.07) | 0.376 |
| OBP (diastolic) | -0.70 (-0.32 to 1.56) | 0.429 |
| HBP(diastolic) | -0.55 (-0.37 to 1.28) | 0.312 |
| CAPD vs APD | 0.71 (-0.42 to 1.76) | 0.234 |
| Albumin | 0.22 (-0.34 to 0.77) | 0.439 |
Funding
- Government Support - Non-U.S.