The Effect of Strict Volume Control Assessed by Repeated Bioimpedance Spectroscopy on Cardiac Function in Peritoneal Dialysis Patients

Yu Ah Hong, Hye Eun Yoon, Bum Soon Choi, Seok Joon Shin, Yong Soo Kim, So Young Lee, Sang Ho Lee, Su Hyun Kim, Eun Young Lee, Sug Kyun Shin, Young Joo Kwon, Jeong Ho Kim, Yoon Kyung Chang, Suk Young Kim, Ji Eun Kim, Shin Young Ahn, Gang Jee Ko

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Abstract

Adequate fluid management plays an important role in decreasing cardiovascular risk in peritoneal dialysis (PD) patients. We evaluated whether strict volume control monitored by bioimpedance spectroscopy (BIS) affects cardiac function in PD patients. This study is a secondary analysis of a multicentre, prospective, randomized, controlled trial. Fluid overload was assessed by the average overhydration/extracellular water (OH/ECW) at baseline, 6 months and 12 months. Patients were categorized as time-averaged overhydrated (TA-OH/ECW ≥15%) or normohydrated (TA-OH/ECW <15%), and echocardiographic parameters were compared between groups. Among a total of 151 patients, 120 patients exhibited time-averaged normohydration. Time-averaged overhydrated patients had a significantly higher left atrial (LA) diameter and E/e′ ratio and a lower left ventricular (LV) ejection fraction at 12 months than time-averaged normohydrated patients. LA diameter, end-systolic volume and end-diastolic volume were decreased at 12 months compared to baseline in time-averaged normohydrated patients only. TA-OH/ECW was independently associated with ejection fraction at 12 months (β = −0.190; p = 0.010). TA-OH/ECW, but not OH/ECW at 12 months, was an independent risk factor for LV dysfunction (odds ratio 4.020 [95% confidence interval 1.285–12.573]). Overhydration status based on repeated BIS measurements is an independent predictor of LV systolic function in PD patients.

Original languageEnglish
Article number17679
JournalScientific reports
Volume9
Issue number1
DOIs
Publication statusPublished - 2019 Dec 1

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ASJC Scopus subject areas

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Cite this

Hong, Y. A., Yoon, H. E., Choi, B. S., Shin, S. J., Kim, Y. S., Lee, S. Y., Lee, S. H., Kim, S. H., Lee, E. Y., Shin, S. K., Kwon, Y. J., Kim, J. H., Chang, Y. K., Kim, S. Y., Kim, J. E., Ahn, S. Y., & Ko, G. J. (2019). The Effect of Strict Volume Control Assessed by Repeated Bioimpedance Spectroscopy on Cardiac Function in Peritoneal Dialysis Patients. Scientific reports, 9(1), [17679]. https://doi.org/10.1038/s41598-019-53792-0