Evaluating Hyponatremia in Non-Diabetic Uremic Patients on Peritoneal Dialysis
| Autor: | Shih-Hua Lin, Sheng-Jeng Peng, Chwei-Shiun Yang, Chih-Jen Cheng, Hsiu-Yuan Wang, Ming-Tso Yan |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment 030232 urology & nephrology Urology Nutritional Status Ultrafiltration Peritoneal dialysis 03 medical and health sciences 0302 clinical medicine Peritoneum Internal medicine Extracellular fluid Electric Impedance medicine Humans Prospective Studies Prospective cohort study Uremia business.industry Sodium Original Articles General Medicine Middle Aged Water-Electrolyte Balance medicine.disease Body Fluids Cross-Sectional Studies medicine.anatomical_structure Endocrinology Nephrology 030220 oncology & carcinogenesis Body Composition Kidney Failure Chronic Female business Hyponatremia Peritoneal Dialysis Fluid volume Non diabetic |
| Zdroj: | Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis. 36:196-204 |
| ISSN: | 1718-4304 0896-8608 |
| DOI: | 10.3747/pdi.2014.00239 |
| Popis: | Background An approach to hyponatremia in uremic patients on peritoneal dialysis (PD) necessitates the assessment of intra-cellular fluid volume (ICV) and extracellular volume (ECV). The aim of the study was to evaluate the association of plasma sodium (Na+) concentration and body fluid composition and identify the causes of hyponatremia in non-diabetic PD patients. Methods Sixty non-diabetic uremic patients on PD were enrolled. Baseline body fluid composition, biochemistry, hand-grip test, peritoneal membrane characteristics, dialysis adequacy, Na+ and water balance, and residual renal function (RRF) were measured. These parameters were reevaluated for those who developed hyponatremia, defined as serum Na+ concentration < 132 mmol/L and a decline in serum Na+ > 7 mmol/L, during monthly visits for 1 year. Body fluid composition was determined by multi-frequency bioelectrical impedance (BIA). Results There was no significant correlation between serum Na+ concentrations and any other parameters except a negative correction with overnight ultrafiltration (UF) amount ( p = 0.02). The ICV/ECV ratio was positively correlated with serum albumin ( p < 0.005) and hand grip strength ( p < 0.05). Over 1 year, 9 patients (M:F = 3:6, aged 35 – 77) with 4 different etiologies of hyponatremia were identified. Hyponatremic patients with a body weight (BW) loss had either an increased ICV/ECV ratio associated with primarily a negative Na+ balance ( n = 2) or a reduced ratio of ICV/ECV associated with malnutrition ( n = 2). In contrast, hyponatremic patients with a BW gain had either a reduced ICV/ECV ratio associated with a rapid loss of RRF and a higher peritoneal permeability ( n = 2) or a normal to increased ICV/ECV ratio associated with high water intake ( n = 3). Conclusion Besides BW change and ultrafiltration rate, the assessment of ICV/ECV ratio is valuable in identifying the etiologies of hyponatremia in PD and provides a guide for optimal therapy. |
| Databáze: | OpenAIRE |
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