Chronic Kidney Disease Clinical Trial
Official title:
Hydratation Status at Initiation of Peritoneal Dialysis: Study of the Role of Peritoneal Permeability
Bioimpedance is recently known to be a reliable, reproducible and validated technic allowing
determination of hydratation status in patients with chronic kidney disease treated with
peritoneal dialysis (PD). Overhydratation attested by bioimpedance is strongly associated
with cardio-vascular morbidity and mortality in patients with PD. Overhydratation might
concern more than half of patients at PD initiation, though the underlying mechanism remains
unknown.
High peritoneal permeability (HPP) might concern about a third of patients starting a PD,
although only a few datas are published on this condition. HPP at initiation of PD is
associated with a decrease in both technical and patient survival and might be responsible of
ultrafiltration failure. The underlying mechanisms of HPP at initiation of PD also remains
unknown.
To our knowledge, the correlation between hydratation status and peritoneal permeability at
initiation of peritoneal dialysis remains unknown. Moreover, there is no datas concerning the
cinetic evolution of peritoneal permeability; demographic or biologic factors associated with
HPP in days and months following PD start.
The aim of the present study is to correlate hydratation status (attested by bioimpedance)
and peritoneal permeability at early start of peritoneal dialysis. Thus, we investigated
early cinetic of peritoneal permeability at different time point during the first year of
peritoneal dialysis and we analyzed the demographical and biological factors associated with
HPP and overhydratation during this period.
This study is a prospective, multicentric cohort study. Fourty patients recruited in a two
years' period in five centers of nephrology will be included. Hydratation status will be
determined with Fluid Overload measurement by bioimpedance technic thanks to BCM system
(Fresenius Medical Care®). Peritoneal permeability will be determined by modified Peritoneal
Equilibration Test with complete drainage at sixty minutes. Datas will prospectively be
collected, including: weight, blood pressure, diuretic posology, diuresis, PD modality,
dialysate prescribed.
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