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Abstract: FR-PO496

Assessment of Fluid Transport Between Extra- and Intraperitoneal Spaces During Peritoneal Dialysis Using Segmental Bioimpedance

Session Information

Category: Dialysis

  • 702 Dialysis: Home Dialysis and Peritoneal Dialysis


  • Zhu, Fansan, Renal Research Institute, New York, New York, United States
  • Rosales, Laura, Renal Research Institute, New York, New York, United States
  • Tisdale, Lela, Renal Research Institute, New York, New York, United States
  • Villarama, Maricar, Mount Sinai Hospital Mount Sinai Heart, New York, New York, United States
  • Kotanko, Peter, Renal Research Institute, New York, New York, United States

In peritoneal dialysis (PD), ultrafiltration (UF) failure is generally attributed to excessive absorption of dialysate from the peritoneal cavity. Currently, we are lacking methods to measure the peritoneal fluid absorption rate. Our goal was to evaluate whether fluid absorption and UF can be assessed by monitoring intraperitoneal fluid volume using segmental bioimpedance analysis (SBIA).


Twenty PD patients were studied during either a peritoneal equilibration test (PET; n=7) or automated PD (APD; n=13). Eight electrodes were placed on the lower abdomen (Fig.1) and connected to a bioimpedance device (Hydra 4200). The abdominal extracellular volume (VABD) was measured comprising the tissues surrounding the peritoneal cavity (VEPF) plus the intraperitoneal (VIPF) fluid (Fig.2). Baseline was defined as the VABD at the state prior to dialysate fill (VIPF = 0). ΔVEPF was calculated after dialysate drainage (VIPF = 0) minus the baseline. ΔVDwell was defined as VABD at the end, minus VABD at the start of the dialysate dwell. The change in ΔVDwell was due to UF or fluid absorption. The clinically measured UF volume (UVFClin) was calculated as the weight of the drained dialysate fluid minus the dialysate fill (2 L; approximated as 2 kg).


UFVClin and UFVSBIA were highly correlated (PET: R2=0.98, p<0.0001; APD: R2=0.94, p<0.0001) (Fig.3). ΔVDwell decreased in eight patients (2 PET; 6 APD) (Fig.4) which indicated absorption of VABD; it was stable in nine patients (4 PET; 5 APD) (Fig.5) and increased in three (1 PET; 2 APD). Stable ΔVEPF (ΔVEPF=0) was observed in three PET patients, allowing us to explore its association with membrane transport status; notably, stable ΔVEPF was associated with high glucose transport.


This pilot study demonstrated a new bioimpedance approach to monitor fluid changes between extra- and intraperitoneal compartments. If confirmed in a larger population, the method may provide a direct measurement of fluid transport across the peritoneal membrane.