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Kidney Week

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
CRP0.10 (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
Diabetes1.49 (-0.13 to 3.12)0.072
Charlson index0.40 (-1.32 to 2.12 )0.649
sOBP0.02 (-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 APD0.71 (-0.42 to 1.76)0.234
Albumin0.22 (-0.34 to 0.77)0.439
   
   
   

Funding

  • Government Support - Non-U.S.