Water removal during automated peritoneal dialysis assessed by remote patient monitoring and modelling of peritoneal tissue hydration

Abstract Water removal which is a key treatment goal of automated peritoneal dialysis (APD) can be assessed cycle-by-cycle using remote patient monitoring (RPM). We analysed ultrafiltration patterns during night APD following a dry day (APDDD; no daytime fluid exchange) or wet day (APDWD; daytime ex...

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Autores principales:	Joanna Stachowska-Pietka, Beata Naumnik, Ewa Suchowierska, Rafael Gomez, Jacek Waniewski, Bengt Lindholm
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/22a8b53607fe4a77b458721c642ac6e5
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spelling	oai:doaj.org-article:22a8b53607fe4a77b458721c642ac6e52021-12-02T17:06:09ZWater removal during automated peritoneal dialysis assessed by remote patient monitoring and modelling of peritoneal tissue hydration10.1038/s41598-021-95001-x2045-2322https://doaj.org/article/22a8b53607fe4a77b458721c642ac6e52021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-95001-xhttps://doaj.org/toc/2045-2322Abstract Water removal which is a key treatment goal of automated peritoneal dialysis (APD) can be assessed cycle-by-cycle using remote patient monitoring (RPM). We analysed ultrafiltration patterns during night APD following a dry day (APDDD; no daytime fluid exchange) or wet day (APDWD; daytime exchange). Ultrafiltration for each APD exchange were recorded for 16 days using RPM in 14 patients. The distributed model of fluid and solute transport was applied to simulate APD and to explore the impact of changes in peritoneal tissue hydration on ultrafiltration. We found lower ultrafiltration (mL, median [first quartile, third quartile]) during first and second vs. consecutive exchanges in APDDD (−61 [−148, 27], 170 [78, 228] vs. 213 [126, 275] mL; p < 0.001), but not in APDWD (81 [−8, 176], 81 [−4, 192] vs. 115 [4, 219] mL; NS). Simulations in a virtual patient showed that lower ultrafiltration (by 114 mL) was related to increased peritoneal tissue hydration caused by inflow of 187 mL of water during the first APDDD exchange. The observed phenomenon of lower ultrafiltration during initial exchanges of dialysis fluid in patients undergoing APDDD appears to be due to water inflow into the peritoneal tissue, re-establishing a state of increased hydration typical for peritoneal dialysis.Joanna Stachowska-PietkaBeata NaumnikEwa SuchowierskaRafael GomezJacek WaniewskiBengt LindholmNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Joanna Stachowska-Pietka Beata Naumnik Ewa Suchowierska Rafael Gomez Jacek Waniewski Bengt Lindholm Water removal during automated peritoneal dialysis assessed by remote patient monitoring and modelling of peritoneal tissue hydration
description	Abstract Water removal which is a key treatment goal of automated peritoneal dialysis (APD) can be assessed cycle-by-cycle using remote patient monitoring (RPM). We analysed ultrafiltration patterns during night APD following a dry day (APDDD; no daytime fluid exchange) or wet day (APDWD; daytime exchange). Ultrafiltration for each APD exchange were recorded for 16 days using RPM in 14 patients. The distributed model of fluid and solute transport was applied to simulate APD and to explore the impact of changes in peritoneal tissue hydration on ultrafiltration. We found lower ultrafiltration (mL, median [first quartile, third quartile]) during first and second vs. consecutive exchanges in APDDD (−61 [−148, 27], 170 [78, 228] vs. 213 [126, 275] mL; p < 0.001), but not in APDWD (81 [−8, 176], 81 [−4, 192] vs. 115 [4, 219] mL; NS). Simulations in a virtual patient showed that lower ultrafiltration (by 114 mL) was related to increased peritoneal tissue hydration caused by inflow of 187 mL of water during the first APDDD exchange. The observed phenomenon of lower ultrafiltration during initial exchanges of dialysis fluid in patients undergoing APDDD appears to be due to water inflow into the peritoneal tissue, re-establishing a state of increased hydration typical for peritoneal dialysis.
format	article
author	Joanna Stachowska-Pietka Beata Naumnik Ewa Suchowierska Rafael Gomez Jacek Waniewski Bengt Lindholm
author_facet	Joanna Stachowska-Pietka Beata Naumnik Ewa Suchowierska Rafael Gomez Jacek Waniewski Bengt Lindholm
author_sort	Joanna Stachowska-Pietka
title	Water removal during automated peritoneal dialysis assessed by remote patient monitoring and modelling of peritoneal tissue hydration
title_short	Water removal during automated peritoneal dialysis assessed by remote patient monitoring and modelling of peritoneal tissue hydration
title_full	Water removal during automated peritoneal dialysis assessed by remote patient monitoring and modelling of peritoneal tissue hydration
title_fullStr	Water removal during automated peritoneal dialysis assessed by remote patient monitoring and modelling of peritoneal tissue hydration
title_full_unstemmed	Water removal during automated peritoneal dialysis assessed by remote patient monitoring and modelling of peritoneal tissue hydration
title_sort	water removal during automated peritoneal dialysis assessed by remote patient monitoring and modelling of peritoneal tissue hydration
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/22a8b53607fe4a77b458721c642ac6e5
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Water removal during automated peritoneal dialysis assessed by remote patient monitoring and modelling of peritoneal tissue hydration

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