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The Effect of Overhydration on Mortality and Technique Failure Among Peritoneal Dialysis Patients: A Systematic Review and Meta-Analysis

Journal

BLOOD PURIFICATION
Volume 46, Issue 4, Pages 350-358

Publisher

KARGER
DOI: 10.1159/000492148

Keywords

Hydration; Fluid overload; Peritoneal dialysis; Prognosis; Bioelectric impedance

Funding

  1. Science and Technology Department of Sichuan Province, China [2016HH0069]
  2. Chengdu Science and Technology Bureau [2015-RK00-00252-ZF]

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Background: Overhydration is common among peritoneal dialysis (PD) patients and can affect PD-related outcomes. This paper aims to systematically investigate whether bio-impedance-assessed overhydration is a predictor for mortality and technique failure in PD patients. Methods: We conducted a systematic review and meta-analysis of cohort studies on overhydration and prognosis in PD patients, strictly complying with the Preferred Reporting Items for Systematical Reviews and Meta-analyses. Results: Eight articles met the selection criteria and 5 studies were included in the meta-analysis. Meta-analyses-revealed overhydration, defined as a high ratio of extracellular water/total body water (ECW/TBW), was significantly associated with higher risk for all-cause mortality and technique failure. Other higher dichotomized overhydration indicators and continuous hydration variables all indicated overhydration as a significant risk factor for all-cause mortality. Conclusion: Overhydration, defined by a higher ratio of ECW/TBW, might be an independent predictor for all-cause mortality and technique failure among PD patients. However, more studies are needed to confirm this conclusion. Video Journal Club 'Cappuccino with Claudio Ronco' at https://www.karger.com/Journal/ArticleNews/223997?sponsor=52 (C) 2018 S. Karger AG, Basel

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