Login to MyKarger

New to MyKarger? Click here to sign up.



Login with Facebook

Forgot your password?

Authors, Editors, Reviewers

For Manuscript Submission, Check or Review Login please go to Submission Websites List.

Submission Websites List

Institutional Login
(Shibboleth or Open Athens)

For the academic login, please select your country in the dropdown list. You will be redirected to verify your credentials.

Original Report: Patient-Oriented, Translational Research

Impact of Diabetes on Extracellular Volume Status in Patients Initiating Peritoneal Dialysis

Udo A.a · Goodlad C.b · Davenport A.b

Author affiliations

aDialysis Unit, University of Uyo Teaching Hospital, Akwa Ibom State, Nigeria; bUCL Centre for Nephrology, University College London, Royal Free Hospital, London, UK

Related Articles for ""

Am J Nephrol 2017;46:18-25

Do you have an account?

Login Information





Contact Information










I have read the Karger Terms and Conditions and agree.



Login Information





Contact Information










I have read the Karger Terms and Conditions and agree.



To view the fulltext, please log in

To view the pdf, please log in

Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.


Save over 20% compared to the individual article price.
Learn more

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restrictions apply

Rental: USD 8.50
Cloud: USD 20.00


Select

Subscribe

  • Access to all articles of the subscribed year(s) guaranteed for 5 years
  • Unlimited re-access via Subscriber Login or MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

Subcription rates


Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview
Abstract of Original Report: Patient-Oriented, Translational Research

Received: January 09, 2017
Accepted: January 31, 2017
Published online: June 01, 2017
Issue release date: July 2017

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 4

ISSN: 0250-8095 (Print)
eISSN: 1421-9670 (Online)

For additional information: https://www.karger.com/AJN

Abstract

Background: Recent reports have highlighted that diabetic patients with kidney failure are at increased risk of technique failure and transfer to haemodialysis within 90 days of initiating peritoneal dialysis (PD). We wished to determine whether there were differences between diabetic and non-diabetic patients within the first 3 months of starting PD. Methods: We reviewed results of corresponding bioimpedance and the 1st test of peritoneal membrane function (PET) in consecutive patients, 6-10 weeks after initiating PD electively. Results: Adult patients numbering 386 - 230 males (59.6%), 152 (39.4%) diabetic, 188 (48.7%) white, mean age 57.3 ±16.9 years - were studied. Although weight, residual renal function and peritoneal clearances were not different, diabetic patients had greater extracellular water to total body water (ECW/TBW; 40.4 ± 1.1 vs. 39.2 ± 1.4) and % ECW excess (9.6 [6.3-12.3] vs. 4.9 [0.7-8.9]), lower serum albumin (35.2 ± 4.7 vs. 37.8 ± 4.9 g/L), greater fat mass index (9.5 ± 4.2 vs. 7.7 ± 4.2), and although mean arterial blood pressure was similar, arterial pulse pressure was greater (66.9 ± 10.8 vs. 54.3 ± 17.3 mm Hg, all p < 0.001). On multivariate analysis, glycated haemoglobin was associated with pulse pressure (standardised β 0.24, p < 0.001), N terminal brain natriuretic peptide (β 0.24, p < 0.001), ECW/TBW (β 0.19, p = 0.012) and negatively with serum albumin (β -0.14, p = 0.033) and creatinine (β -0.18, p = 0.02). Conclusion: Diabetic patients electively starting PD were found to have greater ECW/TBW ratios and ECW excess 6-10 weeks after starting PD compared to non-diabetics, despite similar PET. Increased ECW could predispose diabetic patients to be at greater risk of volume overload.

© 2017 S. Karger AG, Basel


References

  1. Davenport A: Peritonitis remains the major clinical complication of peritoneal dialysis: the London, UK, peritonitis audit 2002-2003. Perit Dial Int 2009;29:297-302.
    External Resources
  2. Fan S, Davenport A: The importance of overhydration in determining peritoneal dialysis technique failure and patient survival in anuric patients. Int J Artif Organs.2015;38:575-579.
  3. Li B, Cairns JA, Fotheringham J, Tomson CR, Forsythe JL, Watson C, Metcalfe W, Fogarty DG, Draper H, Oniscu GC, Dudley C, Johnson RJ, Roderick P, Leydon G, Bradley JA, Ravanan R: Understanding cost of care for patients on renal replacement therapy: looking beyond fixed tariffs. Nephrol Dial Transplant 2015;30:1726-1734.
  4. Pulliam J, Li NC, Maddux F, Hakim R, Finkelstein FO, Lacson E Jr: First-year outcomes of incident peritoneal dialysis patients in the United States. Am J Kidney Dis 2014;64:761-769.
  5. Ozener C, Arikan H, Karayaylali I, Utas C, Bozfakioglu S, Akpolat T, Ataman R, Ersoy F, Camsari T, Yavuz M, Akcicek F, Yilmaz ME: The impact of diabetes mellitus on peritoneal dialysis: the Turkey Multicenter Clinic Study. Ren Fail 2014;36:149-153.
  6. Kim JK, Kim YS, Song YR, Kim HJ, Kim SG, Moon SJ: Excessive weight gain during the first year of peritoneal dialysis is associated with inflammation, diabetes mellitus, and a rapid decrease in residual renal function. PLoS One 2015 25;10:e0139033.
  7. Davenport A, Willicombe MK: Does diabetes mellitus predispose to increased fluid overload in peritoneal dialysis patients? Nephron Clin Pract 2010;114:c60-c66.
  8. Peritoneal Dialysis Adequacy Work Group: Clinical practice guidelines for peritoneal dialysis adequacy. Am J Kid Dis 2006;48(suppl 1):S98-S158.
  9. Davies SJ: Assessment of comorbidity in peritoneal dialysis patients. Contrib Nephrol 2003;140:98-103.
  10. Papakrivopoulou E, Booth J, Pinney J, Davenport A: Comparison of volume status in asymptomatic haemodialysis and peritoneal dialysis outpatients. Nephron Extra 2012;2:48-54.
  11. McCafferty K, Fan S, Davenport A: Extracellular volume expansion, measured by multifrequency bioimpedance, does not help preserve residual renal function in peritoneal dialysis patients. Kidney Int 2014;85:151-157.
  12. John B, Tan BK, Dainty S, Spanel P, Smith D, Davies SJ: Plasma volume, albumin, and fluid status in peritoneal dialysis patients. Clin J Am Soc Nephrol 2010;5:1463-1470.
  13. O'Lone EL, Visser A, Finney H, Fan SL: Clinical significance of multi-frequency bioimpedance spectroscopy in peritoneal dialysis patients: independent predictor of patient survival. Nephrol Dial Transplant 2014;29:1430-1437.
  14. Dandona P, Chaudhuri A, Ghanim H, Mohanty P: Proinflammatory effects of glucose and anti-inflammatory effect of insulin: relevance to cardiovascular disease. Am J Cardiol 2007;99:15B-26B.
  15. Davies SJ, Woodrow G, Donovan K, Plum J, Williams P, Johansson AC, Bosselmann HP, Heimbürger O, Simonsen O, Davenport A, Tranaeus A, Divino Filho JC: Icodextrin improves the fluid status of peritoneal dialysis patients: results of a double-blind randomized controlled trial. J Am Soc Nephrol 2003;14:2338-2344.
  16. Huang N, Chen J, Fan L, Zhou Q, Xu Q, Xu R, Xiong L, Yu X, Mao H: High peritoneal transport status was not associated with mortality in peritoneal dialysis patients with diabetes. PLoS One 2014;9:e110445.
  17. Chang TI, Kang EW, Lee YK, Shin SK: Higher peritoneal protein clearance as a risk factor for cardiovascular disease in peritoneal dialysis patient. PLoS One 2013;8:e56223.
  18. Kocyigit I, Sipahioglu MH, Orscelik O, Unal A, Celik A, Abbas SR, Zhu F, Tokgoz B, Dogan A, Oymak O, Kotanko P, Levin NW: The association between arterial stiffness and fluid status in peritoneal dialysis patients. Perit Dial Int 2014;34:781-790.
  19. Lambert J, Pijpers R, van Ittersum FJ, Comans EF, Aarsen M, Pieper EJ, Donker AJ, Stehouwer CD: Sodium, blood pressure, and arterial distensibility in insulin-dependent diabetes mellitus. Hypertension 1997;30:1162-1168.
  20. Kusche-Vihrog K, Schmitz B, Brand E: Salt controls endothelial and vascular phenotype. Pflugers Arch 2015;467:499-512.
  21. Li PK, Culleton BF, Ariza A, Do JY, Johnson DW, Sanabria M, Shockley TR, Story K, Vatazin A, Verrelli M, Yu AW, Bargman JM; IMPENDIA and EDEN Study Groups: Randomized, controlled trial of glucose-sparing peritoneal dialysis in diabetic patients. J Am Soc Nephrol 2013;24:1889-1900.
  22. Jones CH, Wells L, Stoves J, Farquhar F, Woodrow G: Can a reduction in extracellular fluid volume result in increased serum albumin in peritoneal dialysis patients? Am J Kidney Dis 2002;39:872-875.
  23. Courivaud C, Davenport A: Measurement and interpretation of serum sodium in end-stage kidney disease patients. Semin Dial 2014;27:542-544.
  24. El-Kateb S, Sridharan S, Farrington K, Davenport A: Comparison of resting and total energy expenditure in peritoneal dialysis patients and body composition measured by dual-energy X-ray absorptiometry. Eur J Clin Nutr 2016;70:1337-1339.
  25. Davies SJ, Davenport A: The role of bioimpedance and biomarkers in helping to aid clinical decision-making of volume assessments in dialysis patients. Kidney Int 2014;86:489-496.
  26. Park JI, Bae E, Kim YL, Kang SW, Yang CW, Kim NH, Lee JP, Kim DK, Joo KW, Kim YS, Lee H: Glycemic control and mortality in diabetic patients undergoing dialysis focusing on the effects of age and dialysis type: a Prospective Cohort Study in Korea. PLoS One 2015;10:e0136085.
  27. Adler A, Casula A, Steenkamp R, Fogarty D, Wilkie M, Tomlinson L, Nitsch D, Roderick P, Tomson CR: Association between glycemia and mortality in diabetic individuals on renal replacement therapy in the U.K. Diabetes Care 2014;37:1304-1311.
  28. Coelho S, Rodrigues A: Hemoglobin A1c in patients on peritoneal dialysis: how should we interpret it? Ther Apher Dial 2014;18:375-382.
  29. Fan S, Davenport A: Does increased glucose exposure lead to increased body fat and reduced lean body mass in anuric peritoneal dialysis patients? Eur J Clin Nutr 2014;68:1253-1254.

Article / Publication Details

First-Page Preview
Abstract of Original Report: Patient-Oriented, Translational Research

Received: January 09, 2017
Accepted: January 31, 2017
Published online: June 01, 2017
Issue release date: July 2017

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 4

ISSN: 0250-8095 (Print)
eISSN: 1421-9670 (Online)

For additional information: https://www.karger.com/AJN


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.