Sunday, February 16, 2014

Prevalence of and associations with reduced exercise capacity in peritoneal dialysis patients.

Prevalence of and associations with reduced exercise capacity in peritoneal dialysis patients.
Am J Kidney Dis. 2013 Nov;62(5):939-46
Authors: Zuo ML, Yue WS, Yip T, Ng F, Lam KF, Yiu KH, Lui SL, Tse HF, Siu CW, Lo WK

BACKGROUND: Exercise capacity is reduced in patients with end-stage renal disease on maintenance home peritoneal dialysis therapy, although the potential mechanisms and clinical implications remain unclear.
STUDY DESIGN: Cross-sectional study.
SETTING & PARTICIPANTS: 95 ambulatory prevalent and incident peritoneal dialysis patients in a well-established renal dialysis center (mean age, 58.26 ± 12.6 [SD] years; 63% men; mean duration of peritoneal dialysis therapy, 3.2 ± 4.1 years).
PREDICTOR: Estimated volume status using spectral bioelectrical impedance, echocardiography-derived hemodynamic parameters.
OUTCOME: Exercise capacity measured as peak oxygen consumption using symptom-limiting treadmill exercise testing.
RESULTS: Exercise capacity was reduced in 96% of patients and severely reduced in 65%. Extracellular to intracellular fluid volume ratio showed the strongest correlation with reduced exercise capacity (R = -0.63; P < 0.001) and was superior to age, pulmonary capillary wedge pressure (E:E' ratio), lean tissue mass index, and hemoglobin and albumin levels in predicting exercise intolerance.
LIMITATIONS: Relatively small sample size and echocardiogram that was performed only at rest.
CONCLUSIONS: There was a strong relationship between body extracellular to intracellular fluid volume ratio and exercise capacity in peritoneal dialysis patients. These findings provide new evidence for a connection between fluid distribution, muscle mass, and exercise capacity. Therapeutic strategies targeting fluid status and muscle mass may improve the exercise capacity of patients on peritoneal dialysis therapy.

Read More

Streamlining Clinical Trials: Enhancing Efficiency and Affordability for Medical Innovation

Randomized controlled trials (RCTs) have become more expensive, with median costs estimated at $41,413 per patient for trials conducted betw...

Popular Posts