Hemodialysis (HD) versus Peritoneal Dialysis (PD): Latent Overhydration in PD Patients?

Abstract

Data on the difference in fluid status between hemodialysis (HD) and peritoneal dialysis (PD) patients are scarce. Bio-electrical impedance analysis (BIA) is able to detect total body water (TBW) and its distribution in intracellular (ICW) and extracellular water (ECW). Echographic determination of the diameter of the inferior caval vein (VCD) provides information about the intravascular space (IVS). Nineteen PD-patients and 20 HD-patients in stable clinical condition were studied. In HD-patients a significant decrease in VCD, mean arterial pressure (MAP), TBW and ECW was noted due to ultrafiltration. Both ratios of VCD to ICW/ECW and of VCD to ECW/TBW decreased. No significant differences were found in these variables between PD-patients and HD-patients before HD. In both patient groups the measured variables pointed towards overhydration and the increased ratios both of VCD to ICW/ECW and VCD to ECW/TBW towards the storage of surplus of fluid in the intravascular space. It can be concluded that both PD-patients and HD-patients before HD have a surplus of fluid in the extracellular compartment, predominantly stored in the intravascular space.