Effects of volume status on body composition in incident peritoneal dialysis patients

Background Inadequate fluid removal or high water intake leads to overhydration, which results in malnutrition. The aim of the present study was to evaluate the effects of volume status on body composition in incident peritoneal dialysis (PD) patients. Methods All incident PD patients who survived ≥...

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Bibliographic Details
Published in:European journal of clinical nutrition 2020-04, Vol.74 (4), p.633-641
Main Authors: Kang, Seok Hui, Do, Jun Young
Format: Article
Language:English
Subjects:
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692/699/1585
Albumins
Body composition
Body fat
Clinical Nutrition
Continuous ambulatory peritoneal dialysis
Correlation coefficient
Correlation coefficients
Dialysis
Edema
Epidemiology
Glucose
Health aspects
Internal Medicine
Malnutrition
Medicine
Medicine & Public Health
Metabolic Diseases
Muscles
Patient outcomes
Peritoneal dialysis
Peritoneum
Public Health
Sarcopenia
Subgroups
Water intake
Water intakes
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Summary:Background Inadequate fluid removal or high water intake leads to overhydration, which results in malnutrition. The aim of the present study was to evaluate the effects of volume status on body composition in incident peritoneal dialysis (PD) patients. Methods All incident PD patients who survived ≥1 year after PD initiation were considered eligible. A total of 366 incident PD patients were finally included and divided into three tertiles according to the time-averaged-edema index (TA-EI). The body composition parameters measured using bioimpedance analysis included the EI, fat mass index (FMI, kg/m 2 ), and appendicular muscle mass index (AMMI, kg/m 2 ). dFMI and dAMMI were defined as delta values for each variable. The cutoff value for sarcopenia (SP) was defined as previously reported. Patients with AMMI below the cutoff values were defined as having SP. Results The number of participants in the low, middle, and high tertiles was 126, 100, and 140, respectively. A high volume status was associated with high solute clearance, albumin loss, and glucose absorption through the peritoneal membrane, which led to high dialysate glucose. In addition, volume status was inversely associated with increases in AMMI, but was not associated with changes in FMI. SP as a categorical variable was positively associated with a high volume status. On subgroup analyses, TA-EI had the greatest negative correlation coefficients for dAMMI. Conclusion Overhydration in PD patients was associated with decrease in muscle mass indices and the development of SP.
ISSN:0954-3007
1476-5640
DOI:10.1038/s41430-020-0574-y