VOLUME OVERLOAD IS ASSOCIATED WITH MALNUTRITION IN PERITONEAL DIALYSIS

Abstract

Chronic inflammation is one of the main causes of malnutrition in end stage renal disease (ESRD). Volume overload is prevalent in ESRD patients, and is associated chronic inflammatory process. We evaluated the association of nutritional status with volume overload in peritoneal dialysis patients and the long term effect of volume overload. 98 patients were enrolled and total 78 patients completed the study. Body composition was measured using body composition monitor (BCM, FMC):overhydration(OH), lean tissue mass(LTM) ,fat tissue mass(ATM). Geriatric nutritional risk index (GNRI = [14.89×albumin (g/dl)]+[41.7×body weight/ideal body weight]) were also used as a nutritional parameter. The patients with excess fluid had lower GNRI, with less LTM and ATM at the beginning of the study and the results remained similar after the completion of the study. During 3-year follow up, 11 patients (14%) died. All-cause mortality was significantly increased in fluid overload state (unadjusted hazard ratio 1.34). OH (−0.5 ∼ 1.1L) OH (1.1L ∼ 2.5L) OH (2.5L ∼ ) p value GNRI 0m 105.29±10.9A 101.31±8.42B 95.76±10.51A,B 0.000 24m 105.03±6.94A’ 101.94±4.6B’ 98.85±7.96A’,B’ 0.029 Volume overload is associated with malnutrition and seems to be an independent predictor of mortality in PD population. Further study should evaluate the effects of intervention of volume control in PD patients.