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Verfasst von:Jotterand Drepper, Valérie [VerfasserIn]   i
 Kihm, Lars Philipp [VerfasserIn]   i
 Kälble, Florian [VerfasserIn]   i
 Diekmann, Christian [VerfasserIn]   i
 Seckinger, Jörg [VerfasserIn]   i
 Sommerer, Claudia [VerfasserIn]   i
 Zeier, Martin [VerfasserIn]   i
 Schwenger, Vedat [VerfasserIn]   i
Titel:Overhydration is a strong predictor of mortality in peritoneal dialysis patients
Titelzusatz:independently of cardiac failure
Verf.angabe:Valérie Jotterand Drepper, Lars P. Kihm, Florian Kälble, Christian Diekmann, Joerg Seckinger, Claudia Sommerer, Martin Zeier, Vedat Schwenger
E-Jahr:2016
Jahr:14 July 2016
Teil:volume:11
 year:2016
 number:7
Fussnoten:Gesehen am 14.01.2019
Titel Quelle:Enthalten in: PLOS ONE
Ort Quelle:San Francisco, California, US : PLOS, 2006
Jahr Quelle:2016
Band/Heft Quelle:11(2016,7) Artikel-Nummer e0158741, 10 Seiten
ISSN Quelle:1932-6203
Abstract:Background Overhydration is a common problem in peritoneal dialysis patients and has been shown to be associated with mortality. However, it still remains unclear whether overhydration per se is predictive of mortality or whether it is mainly a reflection of underlying comorbidities. The purpose of our study was to assess overhydration in peritoneal dialysis patients using bioimpedance spectroscopy and to investigate whether overhydration is an independent predictor of mortality. Methods We analyzed and followed 54 peritoneal dialysis patients between June 2008 and December 2014. All patients underwent bioimpedance spectroscopy measurement once and were allocated to normohydrated and overhydrated groups. Overhydration was defined as an absolute overhydration/extracellular volume ratio > 15%. Simultaneously, clinical, echocardiographic and laboratory data were assessed. Heart failure was defined either on echocardiography, as a reduced left ventricular ejection fraction, or clinically according to the New York Heart Association functional classification. Patient survival was documented up until December 31st 2014. Factors associated with mortality were identified and a multivariable Cox regression model was used to identify independent predictors of mortality. Results Apart from higher daily peritoneal ultrafiltration rate and cumulative diuretic dose in overhydrated patients, there were no significant differences between the 2 groups, in particular with respect to gender, body mass index, comorbidity and cardiac medication. Mortality was higher in overhydrated than in euvolemic patients. In the univariate analysis, increased age, overhydration, low diastolic blood pressure, raised troponin and NTproBNP, hypoalbuminemia, heart failure but not CRP were predictive of mortality. After adjustment, only overhydration, increased age and low diastolic blood pressure remained statistically significant in the multivariate analysis. Conclusions Overhydration remains an independent predictor of mortality even after adjustment for heart failure in peritoneal dialysis patients and should therefore be actively sought and managed in order to improve survival in this population.
DOI:doi:10.1371/journal.pone.0158741
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext ; Verlag: http://dx.doi.org/10.1371/journal.pone.0158741
 Volltext: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0158741
 DOI: https://doi.org/10.1371/journal.pone.0158741
Datenträger:Online-Ressource
Sprache:eng
Sach-SW:Absorption spectroscopy
 Biomarkers
 Blood pressure
 Dose prediction methods
 Heart failure
 Medical dialysis
 Multivariate analysis
 Troponin
K10plus-PPN:1586206583
Verknüpfungen:→ Zeitschrift

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