BLOOD PRESSURE, VOLUME, AND SODIUM CONTROL IN AN AUTOMATED PERITONEAL DIALYSIS POPULATION

⇔ Objectives: To examine the control of blood pressure and volume, and the role of sodium removal in a single, large, contemporary, automated peritoneal dialysis (APD) population where icodextrin is used liberally and there is a policy to avoid long duration glucose-based daytime dwells. ⇔ Design: Observational cross-sectional study. ⇔ Setting: A university hospital. ⇔ Patients: 56 APD patients, with a mean duration on peritoneal dialysis of 1.9 years; 50% were prescribed icodextrin. ⇔ Main Outcome Measures: Blood pressure, extracellular water volume (ECW)-to-intracellular water volume (ICW) ratio, and total (peritoneal and urinary) sodium removal. ⇔ Results: Sodium Removal: Mean total sodium removal, while low at 102.9 ± 64.6 mmol/day, showed a wide range, with 41% having a sodium removal of >120 mmol/day. Total sodium removal correlated with total body water, ECW, and ICW (p 140 mmHg and 1 (2%) having a diastolic BP > 80 mmHg. Median number of antihypertensives was 1 per day. Blood pressure control and ECW/ICW ratio were similar in those with sodium removal >120 mmol/day compared to those with sodium removal ≤ ≤ ≤ ≤ ≤120 mmol/day (p = 0.39 for SBP, p = 0.70 for diastolic BP, p = 0.24 for ECW/ICW). ⇔ Conclusions: We have shown that good blood pressure and volume control is achievable in a large contemporary APD population with liberal use of icodextrin and avoidance of long daytime glucose-based dwells. Neither low nor high sodium removal was associated with more frequent hypertension or volume expansion. Perit Dial Int 2007; 27:537‐543 www.PDIConnect.com