Bioimpedance spectroscopy-guided fluid management in peritoneal dialysis patients with residual kidney function: A randomized controlled trial

Hye Eun Yoon, Young-Joo Kwon, Seok Joon Shin, So Young Lee, Sangho Lee, Su Hyun Kim, Eun Young Lee, Sug Kyun Shin, Yong Soo Kim

Research output: Contribution to journalArticle

Abstract

Aim: Bioimpedance spectroscopy (BIS) allows volume status to be assessed objectively. This study evaluated the effect of BIS-guided fluid management on residual kidney function (RKF), volume status, and cardiovascular events in peritoneal dialysis (PD) patients. Methods: A multicenter, prospective, randomized, controlled trial was conducted over 12 months in 2013–2017. Non-anuric PD patients (urine volume ≥ 500 mL/day) were randomized to clinical method-guided management (n = 98) or BIS-guided management (n = 103). The volume in the BIS group was controlled with BIS, with the aim of achieving the target overhydration (OH) goal of −2.0 to +2.0 L. The volume in the control group was controlled by clinical assessment alone. The groups were compared in terms of change in RKF and volume status at 12 months relative to baseline and in terms of cardiovascular event rates during a median follow-up period of 36 months. Results: Compared with the controls, the BIS group did not show a significant improvement in change in OH, after adjustments were made for covariates (P = 0.191). The two groups did not differ in terms of delta OH, renal creatinine and urea clearance, and 24 h urine volume. The control and BIS groups also did not differ significantly in terms of change in peritoneal ultrafiltration volume, blood pressure, body weight and echocardiographic variables or in cardiovascular event rates (10.2% vs 11.3%; P = 0.953). Conclusion: Bioimpedance spectroscopy-guided fluid management did not show an additional benefit to achieve euvolemia, and did not affect the decline in RKF in non-anuric PD patients.

Original languageEnglish
JournalNephrology
DOIs
Publication statusPublished - 2019 Jan 1

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Peritoneal Dialysis
Spectrum Analysis
Randomized Controlled Trials
Kidney
Urine
Ultrafiltration
Urea
Creatinine
Body Weight
Blood Pressure
Control Groups

Keywords

  • bioimpedance
  • cardiovascular
  • euvolemia
  • peritoneal dialysis
  • residual kidney function
  • volume

ASJC Scopus subject areas

  • Nephrology

Cite this

Bioimpedance spectroscopy-guided fluid management in peritoneal dialysis patients with residual kidney function : A randomized controlled trial. / Yoon, Hye Eun; Kwon, Young-Joo; Shin, Seok Joon; Lee, So Young; Lee, Sangho; Kim, Su Hyun; Lee, Eun Young; Shin, Sug Kyun; Kim, Yong Soo.

In: Nephrology, 01.01.2019.

Research output: Contribution to journalArticle

Yoon, Hye Eun ; Kwon, Young-Joo ; Shin, Seok Joon ; Lee, So Young ; Lee, Sangho ; Kim, Su Hyun ; Lee, Eun Young ; Shin, Sug Kyun ; Kim, Yong Soo. / Bioimpedance spectroscopy-guided fluid management in peritoneal dialysis patients with residual kidney function : A randomized controlled trial. In: Nephrology. 2019.
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abstract = "Aim: Bioimpedance spectroscopy (BIS) allows volume status to be assessed objectively. This study evaluated the effect of BIS-guided fluid management on residual kidney function (RKF), volume status, and cardiovascular events in peritoneal dialysis (PD) patients. Methods: A multicenter, prospective, randomized, controlled trial was conducted over 12 months in 2013–2017. Non-anuric PD patients (urine volume ≥ 500 mL/day) were randomized to clinical method-guided management (n = 98) or BIS-guided management (n = 103). The volume in the BIS group was controlled with BIS, with the aim of achieving the target overhydration (OH) goal of −2.0 to +2.0 L. The volume in the control group was controlled by clinical assessment alone. The groups were compared in terms of change in RKF and volume status at 12 months relative to baseline and in terms of cardiovascular event rates during a median follow-up period of 36 months. Results: Compared with the controls, the BIS group did not show a significant improvement in change in OH, after adjustments were made for covariates (P = 0.191). The two groups did not differ in terms of delta OH, renal creatinine and urea clearance, and 24 h urine volume. The control and BIS groups also did not differ significantly in terms of change in peritoneal ultrafiltration volume, blood pressure, body weight and echocardiographic variables or in cardiovascular event rates (10.2{\%} vs 11.3{\%}; P = 0.953). Conclusion: Bioimpedance spectroscopy-guided fluid management did not show an additional benefit to achieve euvolemia, and did not affect the decline in RKF in non-anuric PD patients.",
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AU - Yoon, Hye Eun

AU - Kwon, Young-Joo

AU - Shin, Seok Joon

AU - Lee, So Young

AU - Lee, Sangho

AU - Kim, Su Hyun

AU - Lee, Eun Young

AU - Shin, Sug Kyun

AU - Kim, Yong Soo

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N2 - Aim: Bioimpedance spectroscopy (BIS) allows volume status to be assessed objectively. This study evaluated the effect of BIS-guided fluid management on residual kidney function (RKF), volume status, and cardiovascular events in peritoneal dialysis (PD) patients. Methods: A multicenter, prospective, randomized, controlled trial was conducted over 12 months in 2013–2017. Non-anuric PD patients (urine volume ≥ 500 mL/day) were randomized to clinical method-guided management (n = 98) or BIS-guided management (n = 103). The volume in the BIS group was controlled with BIS, with the aim of achieving the target overhydration (OH) goal of −2.0 to +2.0 L. The volume in the control group was controlled by clinical assessment alone. The groups were compared in terms of change in RKF and volume status at 12 months relative to baseline and in terms of cardiovascular event rates during a median follow-up period of 36 months. Results: Compared with the controls, the BIS group did not show a significant improvement in change in OH, after adjustments were made for covariates (P = 0.191). The two groups did not differ in terms of delta OH, renal creatinine and urea clearance, and 24 h urine volume. The control and BIS groups also did not differ significantly in terms of change in peritoneal ultrafiltration volume, blood pressure, body weight and echocardiographic variables or in cardiovascular event rates (10.2% vs 11.3%; P = 0.953). Conclusion: Bioimpedance spectroscopy-guided fluid management did not show an additional benefit to achieve euvolemia, and did not affect the decline in RKF in non-anuric PD patients.

AB - Aim: Bioimpedance spectroscopy (BIS) allows volume status to be assessed objectively. This study evaluated the effect of BIS-guided fluid management on residual kidney function (RKF), volume status, and cardiovascular events in peritoneal dialysis (PD) patients. Methods: A multicenter, prospective, randomized, controlled trial was conducted over 12 months in 2013–2017. Non-anuric PD patients (urine volume ≥ 500 mL/day) were randomized to clinical method-guided management (n = 98) or BIS-guided management (n = 103). The volume in the BIS group was controlled with BIS, with the aim of achieving the target overhydration (OH) goal of −2.0 to +2.0 L. The volume in the control group was controlled by clinical assessment alone. The groups were compared in terms of change in RKF and volume status at 12 months relative to baseline and in terms of cardiovascular event rates during a median follow-up period of 36 months. Results: Compared with the controls, the BIS group did not show a significant improvement in change in OH, after adjustments were made for covariates (P = 0.191). The two groups did not differ in terms of delta OH, renal creatinine and urea clearance, and 24 h urine volume. The control and BIS groups also did not differ significantly in terms of change in peritoneal ultrafiltration volume, blood pressure, body weight and echocardiographic variables or in cardiovascular event rates (10.2% vs 11.3%; P = 0.953). Conclusion: Bioimpedance spectroscopy-guided fluid management did not show an additional benefit to achieve euvolemia, and did not affect the decline in RKF in non-anuric PD patients.

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KW - volume

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