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Original ArticlesMaintenance Dialysis
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Bioimpedance Guided Fluid Management in Peritoneal Dialysis

A Randomized Controlled Trial

Na Tian, Xiao Yang, Qunying Guo, Qian Zhou, Chunyan Yi, Jianxiong Lin, Peiyi Cao, Hongjian Ye, Menghua Chen and Xueqing Yu
CJASN May 2020, 15 (5) 685-694; DOI: https://doi.org/10.2215/CJN.06480619
Na Tian
1Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
2Key Laboratory of Nephrology, National Health Commission and Guangdong Province, Guangzhou, Guangdong, China
3Department of Nephrology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
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Xiao Yang
1Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
2Key Laboratory of Nephrology, National Health Commission and Guangdong Province, Guangzhou, Guangdong, China
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  • ORCID record for Xiao Yang
Qunying Guo
1Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
2Key Laboratory of Nephrology, National Health Commission and Guangdong Province, Guangzhou, Guangdong, China
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Qian Zhou
4Department of Medical Statistics, Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
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Chunyan Yi
1Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
2Key Laboratory of Nephrology, National Health Commission and Guangdong Province, Guangzhou, Guangdong, China
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Jianxiong Lin
1Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
2Key Laboratory of Nephrology, National Health Commission and Guangdong Province, Guangzhou, Guangdong, China
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Peiyi Cao
1Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
2Key Laboratory of Nephrology, National Health Commission and Guangdong Province, Guangzhou, Guangdong, China
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Hongjian Ye
1Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
2Key Laboratory of Nephrology, National Health Commission and Guangdong Province, Guangzhou, Guangdong, China
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Menghua Chen
3Department of Nephrology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
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Xueqing Yu
1Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
2Key Laboratory of Nephrology, National Health Commission and Guangdong Province, Guangzhou, Guangdong, China
5Department of Nephrology, Guangdong Provincial People’s Hospital, Guangzhou, Guangdong, China
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Abstract

Background and objectives Bioelectrical impedance analysis (BIA) devices can help assess volume overload in patients receiving maintenance peritoneal dialysis. However, the effects of BIA on the short-term hard end points of peritoneal dialysis lack consistency. This study aimed to test whether BIA-guided fluid management could improve short-term outcomes in patients on peritoneal dialysis.

Design, setting, participants, & measurements A single-center, open-labeled, randomized, controlled trial was conducted. Patients on prevalent peritoneal dialysis with volume overload were recruited from July 1, 2013 to March 30, 2014 and followed for 1 year in the initial protocol. All participants with volume overload were 1:1 randomized to the BIA-guided arm (BIA and traditional clinical methods) and control arm (only traditional clinical methods). The primary end point was all-cause mortality and secondary end points were cardiovascular disease mortality and technique survival.

Results A total of 240 patients (mean age, 49 years; men, 51%; diabetic, 21%, 120 per group) were enrolled. After 1-year follow-up, 11(5%) patients died (three in BIA versus eight in control) and 21 patients were permanently transferred to hemodialysis (eight in BIA versus 13 in control). The rate of extracellular water/total body water decline in the BIA group was significantly higher than that in the control group. The 1-year patient survival rates were 96% and 92% in BIA and control groups, respectively. No significant statistical differences were found between patients randomized to the BIA-guided or control arm in terms of patient survival, cardiovascular disease mortality, and technique survival (P>0.05).

Conclusions Although BIA-guided fluid management improved the fluid overload status better than the traditional clinical method, no significant effect was found on 1-year patient survival and technique survival in patients on peritoneal dialysis.

  • fluid overload
  • bioelectrical impedance analysis
  • fluid control
  • short-term outcome
  • Control Groups
  • Cardiovascular Diseases
  • Electric Impedance
  • Body Water
  • Survival Rate
  • peritoneal dialysis
  • dialysis
  • Water-Electrolyte Imbalance
  • Maintenance
  • diabetes mellitus
  • Received June 2, 2019.
  • Accepted March 26, 2020.
  • Copyright © 2020 by the American Society of Nephrology
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Clinical Journal of the American Society of Nephrology: 15 (5)
Clinical Journal of the American Society of Nephrology
Vol. 15, Issue 5
May 07, 2020
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Bioimpedance Guided Fluid Management in Peritoneal Dialysis
Na Tian, Xiao Yang, Qunying Guo, Qian Zhou, Chunyan Yi, Jianxiong Lin, Peiyi Cao, Hongjian Ye, Menghua Chen, Xueqing Yu
CJASN May 2020, 15 (5) 685-694; DOI: 10.2215/CJN.06480619

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Bioimpedance Guided Fluid Management in Peritoneal Dialysis
Na Tian, Xiao Yang, Qunying Guo, Qian Zhou, Chunyan Yi, Jianxiong Lin, Peiyi Cao, Hongjian Ye, Menghua Chen, Xueqing Yu
CJASN May 2020, 15 (5) 685-694; DOI: 10.2215/CJN.06480619
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Keywords

  • fluid overload
  • bioelectrical impedance analysis
  • fluid control
  • short-term outcome
  • Control Groups
  • cardiovascular diseases
  • Electric Impedance
  • Body Water
  • Survival Rate
  • peritoneal dialysis
  • dialysis
  • Water-Electrolyte Imbalance
  • Maintenance
  • diabetes mellitus

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