Impact of Bioelectrical Impedance–Guided Fluid Management and Vitamin D Supplementation on Left Ventricular Mass in Patients Receiving Peritoneal Dialysis: A Randomized Controlled Trial
Autor: | Winnie Su, Michael Walsh, Salim Yusuf, Peter J. Margetts, Jackie Bosch, Deborah Zimmerman, K. Scott Brimble, Javier Ganame, Azim S. Gangji, Shun Fu Lee, Arsh K. Jain, Samy Beshay, Jeffrey Perl |
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Rok vydání: | 2022 |
Předmět: |
medicine.medical_specialty
medicine.medical_treatment Body water Urology Placebo Left ventricular hypertrophy Peritoneal dialysis chemistry.chemical_compound Double-Blind Method Electric Impedance Vitamin D and neurology Intravascular volume status Humans Medicine Vitamin D Cholecalciferol business.industry Vitamin D Deficiency medicine.disease chemistry Nephrology Dietary Supplements Hypertrophy Left Ventricular business Hypervolemia Peritoneal Dialysis |
Zdroj: | American Journal of Kidney Diseases. 79:820-831 |
ISSN: | 0272-6386 |
DOI: | 10.1053/j.ajkd.2021.08.022 |
Popis: | Hypervolemia and vitamin D deficiency occur frequently in patients receiving peritoneal dialysis and may contribute to left ventricular (LV) hypertrophy. The effect of bioelectrical impedance analysis (BIA)-guided volume management or vitamin D supplementation on LV mass among those receiving peritoneal dialysis is uncertain.Two-by-two factorial randomized controlled trial.Sixty-five patients receiving maintenance peritoneal dialysis.BIA-guided volume management versus usual care and oral cholecalciferol 50,000 U weekly for 8 weeks followed by 10,000 U weekly for 44 weeks or matching placebo.Change in LV mass at 1 year measured by cardiac magnetic resonance imaging.Total body water decreased by 0.9 + 2.4 (SD) L in the BIA group compared with a 1.5 ± 3.4 L increase in the usual care group (adjusted between-group difference: -2.4 [95% CI, -4.1 to -0.68] L, P = 0.01). LV mass increased by 1.3 ± 14.3 g in the BIA group and decreased by 2.4 ± 37.7 g in the usual care group (between-group difference: +2.2 [95% CI, -13.9 to 18.3] g, P = 0.8). Serum 25-hydroxyvitamin D concentration increased by a mean of 17.2 ± 30.8 nmol/L in the cholecalciferol group and declined by 8.2 ± 24.3 nmol/L in the placebo group (between-group difference: 28.3 [95% CI, 17.2-39.4] nmol/L, P 0.001). LV mass decreased by 3.0 ± 28.1 g in the cholecalciferol group and increased by 2.0 ± 31.2 g in the placebo group (between-group difference: -4.5 [95% CI, -20.4 to 11.5] g, P = 0.6).Relatively small sample size with larger than expected variation in change in LV mass.BIA-guided volume management had a modest impact on volume status with no effect on the change in LV mass. Vitamin D supplementation increased serum vitamin D concentration but had no effect on LV mass.Unrestricted Baxter International extramural grant and the Kidney Foundation of Canada.Registered at ClinicalTrials.gov with study number NCT01045980. |
Databáze: | OpenAIRE |
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