Overhydration may lead to sarcopaenia in peritoneal dialysis patients

Peritoneal dialysis (PD) patients with inadequate fluid removal or high water intake are more likely to have reduced muscle mass indices and develop sarcopaenia, a study has shown.

The investigators included all incident PD patients surviving ≥1 year after PD initiation in this analysis, which sought to examine the effects of volume status on body composition in this population. In total, 366 incident PD patients met the eligibility criteria and were categorized into three tertiles according to the time-averaged-oedema index (TA-EI).

Bioimpedance analysis was conducted to measure the following body composition parameters: EI, fat mass index (FMI, kg/m²) and appendicular muscle mass index (AMMI, kg/m²). Both dFMI and dAMMI were defined as delta values for the corresponding variable.

The cutoff value for sarcopaenia was defined as previously reported. Participants with AMMI below the cutoff values were considered as having sarcopaenia.

Of the participants, 126 were included in the low, 100 in the middle and 140 in the high tertile. A high volume status or overhydration correlated with high solute clearance, albumin loss and glucose absorption through the peritoneal membrane, resulting in high dialysate glucose.

Volume status, on the other hand, was inversely associated with increases in AMMI and did not correlate with changes in FMI. Sarcopaenia as a categorical variable showed a positive association with high volume status. Subgroup analyses revealed that TA-EI had the greatest negative correlation coefficients for dAMMI.

“Inadequate fluid removal or high water intake leads to overhydration, which results in malnutrition,” the investigators noted.