Calculated plasma volume status in hemodialysis patients

Figures & data

Figure 1. Flow chart illustrating the protocol.

Table 1. Clinical and demographic characteristics of HD patients (n = 54).

Variables	Value
Male n (%)	33 (61.11)
Age (years)	54.61 ± 12.63
Dialysis duration (months)	38.05 (23.45, 70.54)
BMI (kg/m^2)	22.04 ± 2.83
Hemoglobin (g/l)	112.25 ± 9.54
Albumin (g/l)	36.15 ± 2.94
Calcium (mmol/l)	2.19 ± 0.14
Phosphorus (mmol/l)	1.57 ± 0.36
PTH (pg/ml)	216.15 (184.43, 359.34)
CRP (mg/l)	1.5 0 ± 0.42
Kt/V urea-dialysis	1.51 ± 0.32
Diabetes n (%)	19 (35.18)
^#Heart disease n (%)	15 (27.78)
Hypertension n(%)	38 (70.37)

HD: hemodialysis; BMI: body mass index; CRP: C-reactive protein; PTH: parathyroid hormone.

Data are shown as the mean ± SD (standard deviation), percentage or median.

^#Including heart failure, coronary heart disease, cardiomyopathy and severe heart valve disease.

Table 2. Correlation between calculated PV and parameters measured by BIA, NT-ProBNP and blood pressure.

	PVS		aPV
Parameters	r	p value	r	p value
TBW	−0.074	0.60	0.721	<0.001*
ECW	−0.089	0.52	0.830	<0.001*
ICW	−0.058	0.68	0.504	<0.001*
OH	0.057	0.68	0.588	<0.001*
ECW/TBW	−0.155	0.23	0.494	<0.001*
NT-ProBNP	0.200	0.111	0.128	0.311
Systolic BP	−0.181	0.150	−0.022	0.862
Diastolic BP	−0.170	0.175	0.076	0.548

PV: plasma volume; BIA: bioelectrical impedance analysis; NT-ProBNP:N-Terminal Pro-Brain Natriuretic Peptide; BP: blood pressure; aPV: actual plasma volume; PVS: plasma volume status; TBW: total body water; ECW: extracellular fluid water; ICW: intracellular fluid water; OH: overhydration; r: correlation coefficient.

*p < 0.01.

Figure 2. Receiver-operating characteristic (ROC) curve analysis showing the prognostic values of PVS (A) and aPV (B) in predicting volume overload.

Figure 3. Correlation between ultrafiltration volume and decreased PVS (A) and aPV (B).

Figure 4. Kaplan-Meier analysis depicting all-cause deaths in HD patients with high and low time-averaged PVS.

Table 3. Comparison of surviving and non-surviving HD patients: potential risk factors associated with mortality (n = 164).

Variables	Non-surviving patients (n = 60)	Surviving patients (n = 104)	p value
Age (years)	60.64 ± 8.53	56.42 ± 7.05	0.002*
Male n (%)	33 (55.00)	52 (50.00)	0.537
Duration (months)	45.42(23.51, 71.21)	39.80 (28.42, 69.54)	0.124
Kt/V urea-dialysis	1.51 ± 0.32	1.48 ± 0.61	0.733
Scr (µmol/l)	589.68 ± 192.71	674.30 ± 304.71	0.067
BUN (mmol/l)	18.71 ± 6.42	24.42 ± 8.11	<0.001*
Uric acid (µmol/l)	347.14 ± 96.34	440.81 ± 123.20	<0.001*
WBC (×10^9/l)	7.01 ± 2.48	6.28 ± 2.34	0.082
Platelets (×10^9/l)	178.42 ± 82.44	181.89 ± 81.47	0.805
Hemoglobin (g/l)	103.48 ± 24.18	102.84 ± 21.22	0.872
TG (mmol/l)	1.75 ± 1.16	1.86 ± 1.12	0.640
TC (mmol/l)	4.04 ± 1.45	4.72 ± 1.37	0.006*
Albumin (g/l)	33.97 ± 5.82	36.64 ± 5.25	0.004*
FBG (mmol/l)	8.38 ± 5.56	6.67 ± 3.03	0.031*
Calcium (mmol/l)	2.25 ± 0.32	2.14 ± 0.42	0.552
Phosphorus (mmol/l)	1.37 ± 0.47	3.73 ± 0.58	0.407
PTH (pg/ml)	282.88 ± 204.71	327.91 ± 258.44	0.370
Peripheral edema n (%)	10(16.7)	10(9.6)	0.218
^#Comorbidities n (%)	52(86.70)	79(79.90)	0.110
Hypertension n (%)	38 (63.30)	64 (61.50)	0.819
Diabetes n (%)	30 (50.00)	42 (43.90)	0.232
Heart disease n (%)	39 (65.00)	60 (57.70)	0.357
CCI	7.35 ± 1.32	6.62 ± 1.24	0.002*
PVS (%)	12.94 ± 10.87	7.45 ± 5.90	0.024*
Time-averaged PVS (%)	12.83 ± 11.20	6.78 ± 6.22	<0.001*

HD: hemodialysis; Scr: serum creatinine; BUN: blood urea nitrogen; WBC: white blood cell; TG: triglycerides; TC: total cholesterol; FBG: fasting blood glucose; PTH: Parathyroid hormone; CCI: Charlson comorbidity index; PVS: plasma volume status.

Data are shown as the Mean ± SD (standard deviation), percentage or median.

*p < 0.05.

^#Including hypertension, diabetes and heart disease.

Table 4. Univariate and multivariate Cox proportional hazard analyses for predicting all-cause mortality.

Variables	Univariate analysis			Multivariate analysis
	HR	95% CI	p value	HR	95% CI	p value
Age	1.061	1.028–1.101	<0.001*	1.041	0.996–1.091	0.076
Duration	1.022	0.895–1.157	0.007*	1.023	0.938–1.041	0.176
BUN	0.931	0.884–0.957	0.001*	0.983	0.929–1.042	0.585
Uric acid	0.994	0.992–0.99	0.001*	0.999	0.995–1.002	0.415
TC	0.799	0.645–0.99	0.040*	1.052	0.828–1.336	0.669
Albumin	0.861	0.814–0.91	<0.001*	0.912	0.846–0.986	0.020*
CCI	1.407	1.145–1.753	0.001*	1.571	1.199–2.055	0.001*
PVS	1.034	1.019–1.058	<0.001*	1.023	0.993–1.055	0.138
Time-averaged PVS	1.064	1.036–1.091	<0.001*	1.033	1.001–1.065	0.042*

HR: hazard ratio; BUN: blood urea nitrogen; TC: total cholesterol; FBG: fasting blood glucose; CCI: Charlson comorbidity index; PVS: plasma volume status.

*p < 0.05.