Chapter 46
Salt and Water Balance
Mathew Tabinor,
Mark Lambie,
Simon J. Davies,
Mathew Tabinor
Renal Research Group, Faculty of Medicine and Applied Clinical Sciences, Keele University, Newcastle-under-Lyme, UK
Search for more papers by this authorMark Lambie
Renal Research Group, Faculty of Medicine and Applied Clinical Sciences, Keele University, Newcastle-under-Lyme, UK
Search for more papers by this authorSimon J. Davies
Renal Research Group, Faculty of Medicine and Applied Clinical Sciences, Keele University, Newcastle-under-Lyme, UK
Search for more papers by this authorMathew Tabinor,
Mark Lambie,
Simon J. Davies,
Mathew Tabinor
Renal Research Group, Faculty of Medicine and Applied Clinical Sciences, Keele University, Newcastle-under-Lyme, UK
Search for more papers by this authorMark Lambie
Renal Research Group, Faculty of Medicine and Applied Clinical Sciences, Keele University, Newcastle-under-Lyme, UK
Search for more papers by this authorSimon J. Davies
Renal Research Group, Faculty of Medicine and Applied Clinical Sciences, Keele University, Newcastle-under-Lyme, UK
Search for more papers by this authorBook Editor(s):Jonathan C. Craig MBChB, DipCH, MMed(Clin Epi), PhD, FAHMS,
Donald A. Molony MD,
Giovanni F.M. Strippoli MD, PhD, MPH, MM (Epi),
Jonathan C. Craig MBChB, DipCH, MMed(Clin Epi), PhD, FAHMS
Matthew Flinders Distinguished Professor Vice President and Executive Dean
College of Medicine and Public Health, Flinders University, Adelaide, Australia
Search for more papers by this authorDonald A. Molony MD
Professor of Medicine Distinguished Teaching Professor of the University of Texas System
Division of Renal Diseases and Hypertension AND Center for Clinical Research and Evidence-based Medicine, McGovern Medical School University of Texas, Houston, TX, USA
Search for more papers by this authorGiovanni F.M. Strippoli MD, PhD, MPH, MM (Epi)
Professor of Nephrology Adjunct Professor of Epidemiology
Department of Emergency and Organ Transplantation – University of Bari, Bari, Italy
School of Public Health, University of Sydney, Sydney, NSW, Australia
Search for more papers by this authorFirst published: 18 November 2022
Summary
Achieving salt and water balance is fundamental to optimizing fluid status, one of the key objectives of peritoneal dialysis (PD) treatment. The relative importance of salt and water management to patient outcomes was historically underestimated by early treatment guidelines, which tended to focus on small solute clearance as the principal metric of dialysis adequacy. Hypertension is common in PD patients and, given the high cardiovascular morbidity and mortality in dialysis patients, it is a crucial aspect of patient management. Bioimpedance is increasingly used to assess body composition in dialysis patients. Given the predictive value of bioimpedance, it is natural to ask if it can be used to guide and thus improve fluid management in dialysis patients. The problems of poor salt and water balance in the context of fast small solute transfer are twofold: early loss of ultrafiltration in the dwell followed by more rapid reabsorption of salt and water.
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