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      Intraperitoneal Pressure in Polycystic and Non-Polycystic Kidney Disease Patients, Treated by Peritoneal Dialysis

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          Abstract

          Introduction: Intraperitoneal volume (IPV) should be individualized and aimed to maintain an intraperitoneal pressure (IPP) lower than 17 cm H<sub>2</sub>O. IPP is very variable, given its relation with body size. However, it is not yet fully understood which anthropometric variable mostly affects IPP and the relation between IPP and organomegaly in polycystic kidney disease (PKD) patients is not known. Objectives: The aim of the present study was to analyse the relation between antropometric variables and IPP in a large cohort of peritoneal dialysis (PD) patients and to identify if a relation between nephromegaly and IPP exists in PKD patients. Methods: IPP was measured in PD patients and data was retrospectively collected. In PKD patients, total kidney volumes were measured in CT scans, and normalized with height (hTKV). Results: Seventy-seven patients were included in the study, 18% affected by PKD. Mean IPP was 14.9 ± 2.9 cm H<sub>2</sub>O and it showed significant positive correlation with body mass index (BMI; ρ = 0.42, p < 0.001). No correlation was found between IPP and absolute IPV; conversely, IPP has a significant inverse correlation with IPV normalized with BMI and body surface area ( ρ –0.38, p = 0.001 and ρ –0.25, p = 0.02, ­respectively). Patients with IPP >17 cm H<sub>2</sub>O have significant larger BMI and lower IPV/BMI compared to those with IPP <17 cm H<sub>2</sub>O (29 ± 3.6 vs. 26 ± 4 kg/m<sup>2</sup>, p < 0.05 and 97 ± 15.5 vs. 109 ± 22 mL/kg/m<sup>2</sup>, p < 0.05). PKD patients have a wide variability in hTKV (range 645–3,787 mL/m<sup>2</sup>) and it showed a significant correlation with IPP/IPV ( ρ = 0.6, p < 0.05). Conclusions: Patients with larger BMI have greater IPP, irrespectively to IPV. In PKD patients, hTKV correlate with IPP/IPV ratio. However, given the wide range of distribution of hTKV, increased IPP cannot be presumed because of pre-existing polycystic kidney, but need to be quantified.

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          Author and article information

          Journal
          BPU
          Blood Purif
          10.1159/issn.0253-5068
          Blood Purification
          S. Karger AG
          0253-5068
          1421-9735
          2020
          November 2020
          25 August 2020
          : 49
          : 6
          : 670-676
          Affiliations
          aDepartment of Nephrology, Dialysis and Transplantation, International Renal Research Institute of Vicenza, San Bortolo Hospital, Vicenza, Italy
          bDivision of Nephrology, Department of Clinical and Molecular Medicine, Sant’ Andrea University Hospital, “Sapienza” University of Rome, Rome, Italy
          cDepartment of Medicine, University of Padua, Padua, Italy
          Author notes
          *Anna Giuliani, Department of Nephrology, Dialysis and Transplantation, International Renal Research Institute of Vicenza, San Bortolo Hospital, Viale Rodolfi 37, IT–36100 Vicenza (Italy), annagiuliani84@gmail.com
          Article
          506177 Blood Purif 2020;49:670–676
          10.1159/000506177
          32841944
          © 2020 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Figures: 3, Tables: 3, Pages: 7
          Categories
          Research Article

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