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Abstract: FR-PO499

Association of Bioimpedance Guided Fluid Management in Patients Receiving Peritoneal Dialysis and Cardiovascular Outcomes: A Systematic Review and Meta-Analysis

Session Information

Category: Dialysis

  • 702 Dialysis: Home Dialysis and Peritoneal Dialysis


  • Almutar, Sara S A S, McMaster University, Hamilton, Ontario, Canada
  • Judge, Conor S., McMaster University, Hamilton, Ontario, Canada
  • Alsadhan, Abdulmajeed Abdullah, McMaster University, Hamilton, Ontario, Canada
  • Brimble, K. Scott, McMaster University, Hamilton, Ontario, Canada
  • Margetts, Peter, McMaster University, Hamilton, Ontario, Canada

Fluid management in patients receiving peritoneal dialysis is a major challenge for nephrologists. This systematic review and meta-analysis evaluates the association with bioimpedance guided fluid management in patients receiving peritoneal dialysis and cardiovascular outcomes.


PubMed, Embase and CENTRAL were searched from database inception to 09-Jan-2022 for randomized clinical trials comparing bioimpedance and clinical examination guided fluid management in patients receiving peritoneal dialysis. A random-effects meta-analysis was used to estimate the pooled treatment-effect. The primary outcome measure was a composite cardiovascular outcome. Secondary outcome measures included all-cause mortality, cardiovascular mortality, hospitalizations, technique failure, change in systolic blood pressure (mmHg), weight (kg) and urine output (ml/day).


Seven trials were eligible for inclusion (n=1238) (mean follow-up: 19 months). The association of bioimpedance guided fluid management compared to clinical examination guided fluid management and cardiovascular outcomes was not-significant (Odds Ratio (OR) 0.81, 95% Confidence Interval (CI),0.49-1.33;Absolute Risk Reduction (ARR) 2.2%,-3to7.1). Bioimpedance guided fluid management compared to clinical examination guided fluid management was associated with a significant reduction in cardiovascular mortality (OR0.50,95%CI,0.26-0.98,ARR4.5%,0.3-8.7), systolic blood pressure (mean reduction -0.2 mmHg [-0.36 to -0.04]) but not all-cause mortality, weight (kg) or residual urine output (ml/day).


Bioimpedance guided fluid management in patients receiving peritoneal dialysis compared to control was not associated with a lower incidence of cardiovascular outcomes. However, bioimpedance guided fluid management, compared to control, was associated with statistically significant lower cardiovascular mortality and lower systolic blood pressure without a reduction in residual urine output.