Blood pressure, volume, and sodium control in an automated peritoneal dialysis population.

Blood pressure, volume, and sodium control in an automated peritoneal dialysis population. Research Abstract Details 

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Blood pressure, volume, and sodium control in an automated peritoneal dialysis population. Abstract Text:

Neil C Boudville,Peter Cordy,Kristie Millman,Laura Fairbairn,Ajay Sharma,Robert Lindsay,Peter G Blake,Neil C Boudville,Peter Cordy,Kristie Millman,Laura Fairbairn,Ajay Sharma,Robert Lindsay,Peter G Blake,

OBJECTIVES: To examine the control of blood pressure and volume, and the role of sodium removal in a single, large, contemporary, automated peritoneal dialysis (APD) population where icodextrin is used liberally and there is a policy to avoid long duration glucose-based daytime dwells. DESIGN: Observational cross-sectional study. SETTING: A university hospital. PATIENTS: 56 APD patients, with a mean duration on peritoneal dialysis of 1.9 years; 50% were prescribed icodextrin. MAIN OUTCOME MEASURES: Blood pressure, extracellular water volume (ECW)-to-intracellular water volume (ICW) ratio, and total (peritoneal and urinary) sodium removal. RESULTS: Sodium Removal: Mean total sodium removal, while low at 102.9 +/- 64.6 mmol/day, showed a wide range, with 41% having a sodium removal of >120 mmol/day. Total sodium removal correlated with total body water, ECW, and ICW (p < 0.001, p < 0.001, p < 0.025, respectively), as well as with height and weight (p < 0.06, p < 0.01 respectively). On multivariate analysis, only ultrafiltration volume and urine volume were significantly associated with total sodium removal (r(2) = 0.67, p < 0.0001 for both). There was also a correlation between sodium removal and urea nitrogen appearance (r(2) = 0.31, p < 0.001), with urea nitrogen appearance in turn being closely correlated with ICW (p < 0.001). Volume Status: The ECW/ICW ratio was 0.88 +/- 0.17, which was not significantly different to that found in hemodialysis patients without clinical evidence of fluid overload, either predialysis (0.96 +/- 0.16) or postdialysis (0.92 +/- 0.16); p = 0.07 and 0.36 respectively. Blood Pressure: Mean +/- standard deviation systolic blood pressure (BP) was 111.9 +/- 18.2 mmHg and diastolic BP was 63.3 +/- 11.9 mmHg, with only 4 (7%) patients having a systolic BP > 140 mmHg and 1 (2%) having a diastolic BP > 80 mmHg. Median number of antihypertensives was 1 per day. Blood pressure control and ECW/ICW ratio were similar in those with sodium removal >120 mmol/day compared to those with sodium removal < or =120 mmol/day (p = 0.39 for SBP, p = 0.70 for diastolic BP, p = 0.24 for ECW/ICW). CONCLUSIONS: We have shown that good blood pressure and volume control is achievable in a large contemporary APD population with liberal use of icodextrin and avoidance of long daytime glucose-based dwells. Neither low nor high sodium removal was associated with more frequent hypertension or volume expansion.

Blood pressure, volume, and sodium control in an automated peritoneal dialysis population. Publishing Authors By Initials

NC Boudville,P Cordy,K Millman,L Fairbairn,A Sharma,R Lindsay,PG Blake,NC Boudville,P Cordy,K Millman,L Fairbairn,A Sharma,R Lindsay,PG Blake,

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Blood pressure, volume, and sodium control in an automated peritoneal dialysis population. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Peritoneal dialysis international : journal of the

VOLUME: 27

Page Numbers: 537-43

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ISSN: 0896-8608

DAY: 20

MONTH: 08

YEAR: 2007

Blood pressure, volume, and sodium control in an automated peritoneal dialysis population. Information

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LANGUAGE: eng

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AFFILIATION: University of Western Australia, Perth, WA, Australia. nboudvil@cyllene.uwa.edu.au

Country: Canada

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MEDLINETA: Perit Dial Int

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