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Kidney Week

Abstract: SA-PO672

CA-125 Is a Good Biomarker of Overhydration in Peritoneal Dialysis Patients

Session Information

  • Home Dialysis - II
    November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Martins, Ana Cristina, Centro Hospitalar de Lisboa Ocidental EPE Hospital de Santa Cruz, Carnaxide, Lisboa, Portugal
  • Pimenta, Gonçalo Félix, Centro Hospitalar de Lisboa Ocidental EPE Hospital de Santa Cruz, Carnaxide, Lisboa, Portugal
  • Calça, Rita, Centro Hospitalar de Lisboa Ocidental EPE Hospital de Santa Cruz, Carnaxide, Lisboa, Portugal
  • Matias, Patrícia, Centro Hospitalar de Lisboa Ocidental EPE Hospital de Santa Cruz, Carnaxide, Lisboa, Portugal
Background

Volume management in peritoneal dialysis (PD) patients is crucial due to the impact of fluid overload on cardiovascular and non-cardiovascular morbimortality. Clinical examination itself has a poor diagnostic accuracy for minor deviations from normohydration, highlighting the necessity for supplementary tools.
The aim of this study was to evaluate the association between serum biomarkers (CA-125 and NT-proBNP) and volume status, assessed through bioimpedance analysis, upon initiation of PD technique and follow-up.

Methods

Single-centre observational cross-sectional study including PD patients that started technique between 2017 and 2023. Demographic and clinical data were collected from electronic records. Parameters evaluated were clinical examination, serum biomarkers, bioimpedance and dialysis adequacy.

Results

A total of 79 patients (51 male) were included with a median age of 59 (IQR 23) years. Baseline (T0) PET showed 77.2% high or high-average transporters. Follow-up (T1) PETs were performed after a median of 18 months (IQR 19). All the patients started with continuous ambulatory peritoneal dialysis (CAPD). Median weekly Kt/V was 2.3 (IQR 0.7). The median residual renal function (RRF) and residual diuresis were 5.9 (IQR 4.9) mL/min/1.73m2 and 1.5 (IQR 1.1) L (5.1% anuric), respectively.
Median CA-125 at T0 and T1 were 16.2 U/mL (IQR 17.8) and 13.4 U/mL (IQR 16.1), respectively, which were not statistically different. The median overhydration index at T0 and T1 was 1.55L (IQR 2.5) and 1.1L (IQR 2.3) (p=.001). There was a positive association between D/P of creatinine and CA-125 (r=.25, p=.03) and a negative association between weekly Kt/V and CA-125 (r=-.25, p=.035), both at T0. There was also a positive association between NTproBNP and CA-125 levels at T1 (r=.44, p<.001) and between the NTproBNP variation from T0 to T1 and the CA-125 variation from T0 to T1 (r=.352, p=.004). There was no association between the variation of hydration status and the variation of NT-proBNP and CA-125 levels.

Conclusion

Serum NT-proBNP and CA-125 show a positive correlation, which suggests these biomarkers might be used interchangeably in the evaluation of the patients’ hydration. Effective management of hypervolemia improves clinical outcomes. Prospective studies are needed to better understand the use of CA-125 as a surrogate marker of hypervolemia.