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Blood Purif. 2018;46(4):350-358. doi: 10.1159/000492148. Epub 2018 Sep 6.

The Effect of Overhydration on Mortality and Technique Failure Among Peritoneal Dialysis Patients: A Systematic Review and Meta-Analysis.

Shu Y1,2, Liu J1, Zeng X1,3, Hong HG4, Li Y5, Zhong H1, Ma L1, Fu P1,3.

Author information

1
Division of Nephrology, Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China.
2
Division of Nephrology, The Third People's Hospital of Chengdu, Chengdu, China.
3
West China Biomedical Big Data Center, Sichuan University, Chengdu, China.
4
Michigan State University, East Lansing, Michigan, USA.
5
University of Michigan, Ann Arbor, Michigan, USA.

Abstract

BACKGROUND:

Overhydration is common among peritoneal dialysis (PD) patients and can affect PD-related outcomes. This paper aims to systematically investigate whether bioimpedance-assessed overhydration is a predictor for mortality and technique failure in PD patients.

METHODS:

We conducted a systematic review and meta-analysis of cohort studies on overhydration and prognosis in PD patients, strictly complying with the Preferred Reporting Items for Systematical Reviews and Meta-analyses.

RESULTS:

Eight articles met the selection criteria and 5 studies were included in the meta-analysis. Meta-analyses-revealed overhydration, defined as a high ratio of extracellular water/total body water (ECW/TBW), was significantly associated with higher risk for all-cause mortality and technique failure. Other higher dichotomized overhydration indicators and continuous hydration variables all indicated overhydration as a significant risk factor for all-cause mortality.

CONCLUSION:

Overhydration, defined by a higher ratio of ECW/TBW, might be an independent predictor for all-cause mortality and technique failure among PD patients. However, more studies are needed to confirm this conclusion. Video Journal Club 'Cappuccino with Claudio Ronco' at https://www.karger.com/Journal/ArticleNews/223997?​sponsor=52.

KEYWORDS:

Bioelectric impedance; Fluid overload; Hydration; Peritoneal dialysis; Prognosis

PMID:
30189422
DOI:
10.1159/000492148
[Indexed for MEDLINE]
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