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- Title
Measuring total body water in peritoneal dialysis patients using an ethanol dilution technique.
- Authors
Dahl, Naomi V.; Foote, Edward F.; Kapoian, Toros; Steward, Caroline A.; Sherman, Richard A.; Dahl, N V; Foote, E F; Kapoian, T; Steward, C A; Sherman, R A
- Abstract
<bold>Unlabelled: </bold>Measuring total body water in peritoneal dialysis patients using an ethanol dilution technique.<bold>Background: </bold>The accuracy with which total body water (TBW) is estimated is a direct determinant of the reliability of Kt/V urea measurements in peritoneal dialysis (PD) patients. Ethanol dilution has been previously shown to be a reliable measure of TBW. Advances in breath alcohol technology make this a feasible clinical tool.<bold>Methods: </bold>We gave 19 fasting chronic PD patients 0.3 g/kg of ethanol (EtOH) orally on two separate occasions. Breath alcohol concentrations (BrACs), determined by dual-beam infrared analysis, were recorded at baseline and periodically thereafter until BrACs were less than 0.01%. The TBW was then determined by standard pharmacokinetic techniques.<bold>Results: </bold>TBW measurements were reproducible, with a mean between-run difference of -0.004 liter/kg (95% limits of agreement -0.040 to 0. 032 by Bland-Altman). The Watson equations tended to underestimate TBW, with a mean difference (EtOH - Watson) of +3.0 liters (SD 4.0 liters, P = 0.004) and a mean absolute difference of 4.1 liters (SD 2.7 liters, range -4.4 to 9.5 liters). Kt/V was calculated from dialysate and urine collection, using V as determined from TBW estimates from EtOH and Watson. The mean Kt/V(EtOH) was 2.31 (SD 0. 50) compared with 2.46 (SD 0.52) using Watson. The mean absolute difference between the two Kt/V estimates was 0.26 (SD 0.20, range -0.87 to 0.57), with Kt/V overestimated by Watson in 14 patients. EtOH was well tolerated, and the procedure was completed in about four hours.<bold>Conclusions: </bold>Measuring V by the BrAC technique does not require blood sampling, is reliable, and is reproducible. It is a potentially useful method for a periodic determination of volume that may allow for more accurate Kt/V measurement in PD patients.
- Subjects
WATER in the body; PERITONEAL dialysis; ALCOHOL; MEASUREMENT; PATIENTS
- Publication
Kidney International, 1999, Vol 56, Issue 6, p2297
- ISSN
0085-2538
- Publication type
journal article
- DOI
10.1038/sj.ki.4491173