VOLUME STATUS IN PERITONEAL DIALYSIS

Fluid homeostasis is one of the fundamental roles of the kidney and a crucial aspect in clinical management of patients on peritoneal dialysis (PD). Volume status has an important impact on the outcome of PD patients. Fluid excess leads to accelerated development of cardiovascular disease. Volume status may also impact on disorders and assessment of nutritional state. While ultrafiltration and residual urine volume have featured prominently in PD research, the importance of fluid intake and thirst in PD patients has received relatively little attention. Despite older studies suggesting that fluid overload is common in PD, current PD techniques can produce sufficient fluid removal to achieve good control of fluid, with associated cardiac benefits in PD patients. One of the major challenges is to apply these techniques to obtain ideal volume status in patients. Bioelectrical impedance analysis appears to be the most promising technique currently available to guide fluid management.