Fluid status of patients during the early stages of continuous ambulatory peritoneal dialysis

L. Wang, W. Yu, T. Wang

Department of Nephrology, Xuzhou No.1 People’s Hospital, Xuzhou, Jangsu Province, China. wangt@bjmu.edu.cn

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• Nephrology

OBJECTIVE: The purpose of this paper is to investigate the fluid status of patients in the early stages of continuous ambulatory peritoneal dialysis (CAPD).

PATIENTS AND METHODS: A total of 36 patients (13 males and 23 females), hospitalized in the Nephrology CAPD Center, Peking University Third Hospital, and undergoing intubation and CAPD treatment, were recruited in this study. By utilize a bioelectrical impedance analyzer, changes in extracellular fluid and intracellular fluid within the patients’ cells, and overall fluid changes were monitored throughout six months following CAPD treatment. Blood pressure was taken before dialysis and during six months following dialysis. Dietary assessment was also performed by recording and analyzing the patients’ dietary protein and caloric intake during this six months period.

RESULTS: Over a six-month period, following CAPD treatment, the fluid status of the patients displayed a rising trend, indicated by weight gain, increasing extracellular fluid (ECW), intracellular fluid (ICW), overall water (TBW) and standardized extracellular fluid (NECW). Peritoneal ultrafiltration volume, and residual urine volume, showed no significant difference before or after treatment. During the six-month period, the dietary caloric intake of patients increased. Prior to CAPD, the patients’ systolic blood pressure level was higher than normal. Following treatment, it returned to normal, and, due to the patients’ rising fluid status, no change occurred during the six-month monitoring period.

CONCLUSIONS: During the early stages of CAPD treatment, patients’ fluid status increased, as a result of dietary improvement and the increased intake of water and salt. However, weight gain, in the early stages of the CAPD, is more likely due to rising fluid status than nutritional improvement. Early control of water and salt intake is of crucial importance for CAPD patients.

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