Kim JK, et al. - Researchers sought to determine the impact of chronic exposure to sustained fluid overload on long-term outcomes in patients undergoing peritoneal dialysis (PD). In prevalent PD patients, 1-year chronic exposure to fluid overload was identified as a strong independent risk factor for transfer to hemodialysis (HD) and death. Becoming euvolemic during the entire PD treatment period seemed to be very important, although the fluid status of most PD patients was not easily changed over time.

• Researchers carried out a prospective study including a total of 284 prevalent PD patients.
• They performed repeated multifrequency body composition analysis 12 months apart, and used 1-year cumulative chronic fluid overload to predict all-cause mortality and the risk for transfer to hemodialysis (HD) during the ensuing 15.6 ± 9.1 months.

• Findings revealed that the prevalence of fluid overload was approximately 27%.
• Second test revealed persistent hypervolemia in a substantial number of patients who were hypervolemic at their first test.
• With this, 18.3% (n = 52) had chronic fluid overload.
• Researchers found that most of chronic fluid overload patients had diabetes (86.5%), and it was accompanied by concomitant changes in peritoneal membrane characteristics, a higher progression rate to high transporter.
• They also noted that in patients with chronic fluid overload vs in those without, the risk of transfer to HD increased 2.8 times.
• Data showed that it significantly increased the risk of mortality (p=0.038).
• Surprisingly, it was demonstrated in subgroup analysis that patients with euvolemic status at follow-up experienced no mortality despite being in a fluid overload state at baseline.