Comparison of bioimpedance spectroscopy and the Watson formula for measuring body volume in patients on peritoneal dialysis

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First, it helps to assess the patient's hydration status, although what is more relevant is he percentage of water relative to the total body composition. However, the absolute value of V is used as the denominator in the Kt/V equation; therefore, it is a key element to know the dialysis efficiency.The most common way to determine V in dialysis patients is by anthropometric mathematical formulas, which are simple and easily applicable. The most commonly used in the general population, almost universally, is the Watson formula.<a class="elsevierStyleCrossRef" href="#bib0005">1</a>However, this equation has not been validated in patients with different pathologies, particularly in dialysis patients. The Watson formula uses patient's sex, age, weight and height, but it does not take into account the body composition nor the distribution of water in patients on PD as compared to general population.<a class="elsevierStyleCrossRefs" href="#bib0010">2–4</a>Recently, dialysis centers are using the bioimpedance spectroscopy (BIS) technique in both hemodialysis<a class="elsevierStyleCrossRefs" href="#bib0025">5,6</a> and PD<a class="elsevierStyleCrossRefs" href="#bib0035">7–10</a> patients. This technique uses a low intensity multifrequency alternating current passing through the patient's body to determine a number of nutritional and hydration parameters, including the V.<a class="elsevierStyleCrossRef" href="#bib0055">11</a> BIS measurement is a simple, painless and risk-free technique. Frequently, BIS measurements are replacing the traditional anthropometric formulas as a method to determine V in dialysis patients, or even both methods are used to calculate V. However, sometimes, in the same patient the values of V obtained with these two methods are considerably different which generates uncertainty about which of the two V values should be accepted as valid.The purpose of this study is, first, to assess whether there are differences in V measurements in PD patients using BIS and an anthropometric formula (Watson formula), and second, to assess which factors may influence the occurrence of these differences.Patients and methodsWe conducted a prospective observational study involving 74 PD patients, 42 males (56.76%) and 32 females (43.24%) with an average age of 59, 98±16, 96 (range 24.13 and 82.98 years). The causes of renal failure were diabetic nephropathy (25.68%), followed by chronic tubulointerstitial nephropathy (22.97%), chronic glomerulonephritis (18.92%), nephrosclerosis (12.16%), hepatorenal polycystic disease (6.76%) and ischemic nephropathy (2.70%), while the etiology was unknown in 10.81%. Continuous ambulatory peritoneal dialysis (CAPD) was used in 41 patients (55.41%), while automated peritoneal dialysis (APD) was used in 33 (44.59%). According to the peritoneal transport as measured by D/P creatinine, 47.97% were in the medium-low average transport, 47.60 in the medium-high, 2.58% in the high and 1.85% in the low. The criteria to apply CAPD or APD was the patient's personal choice. Exclusion criteria for this study were the unability to perform the BIS test accurately: presence of major amputations and being a carrier of metal components such as stents, pacemakers, prosthetic joints or defibrillators.Values of height and weight were obtained in each patient and a measurement of body volume by BIS (Body Composition Monitor: Fresenius Medical Care) for total body volume (Vbis) was performed. Also a measurement of hydration, extracellular water, intracellular water and E/I ratio was carried out. BIS was performed after fasting, without diálisis<a class="elsevierStyleCrossRef" href="#bib0060">12</a> solution in the abdomen and with an empty bladder in those patients who maintained residual kidney function. The body volume was also calculated using the standard Watson equation (Vw) (men: V=2.447−(0.09156×age)+(0.1074×height)+(0.3362×weight); women: V=(0.1096×height)+(0.2466×weight)−2.097). Once the volume was obtained by both methods, patients were separated into two groups according to the difference obtained using the two methods: ≥10% or <10% of Vbis (these percentages are above the standard error of V measurements using BIS, which is estimated at 5%,). In total, we have 271 volume measurements from the 74 patients previously described. The volumes are expressed as arithmetic mean plus standard deviation. Student t test was used to analyze whether the difference between Vbis and Vw was significant. In turn, we performed a Bland Altman test to evaluate the correlation between the 2 methods.In each patient, a number of features considered potentially responsible for generating differences between volumes were recorded.<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005">-Personal parameters: age (≥65 or <65 years) and sex (male or female).</li><li class="elsevierStyleListItem" id="lsti0010">-Clinical and pathological parameters: presence or absence of hypertension (defined as taking at least 2 antihypertensive drugs), dyslipidemia, diabetes mellitus (DM), ischemic heart disease, neuropathy, peripheral vascular disease measured by ankle-brachial index and the use of antiplatelets aggregation agents or anticoagulants.</li><li class="elsevierStyleListItem" id="lsti0015">-Parameters associated with dialysis: type of PD (CAPD or APD), peritoneal transport (D/P Cr ≥0.65 or <0.65) and presence of residual diuresis (defined as greater than or equal to 400cc/24h).</li><li class="elsevierStyleListItem" id="lsti0020">-Nutritional and inflammatory parameters: E/I ratio measured by BIS (≥1 or <1), obesity (BMI ≥30 or <30kg/m2), % of body fat by BIS (≥25 or <25% in men and 30% in women), prealbumin (≥25 or <25mg/dl), hypoalbuminemia (serum albumin ≥3.5 or <3.5g/dl), phase angle at 50Hz (greater or lower than average phase angle at 50Hz obtained in all analyzed patients: 4.31°) and CRP (≥5 or <5mg/l).</li></ul>Subsequently, we used the chi-square test to assess whether there is an association between the differences in volume and the presence or absence of the described clinical parameters.All statistical tests (Student t test, Bland Altman test and chi square test) were performed by using SPSS 15.0 for Windows, being p<0.05 considered as significant.ResultsWe assessed the presence or absence of a number of factors and clinical parameters in patients and in the way measurements were carried out. This information is shown in <a class="elsevierStyleCrossRefs" href="#tbl0005">Tables 1 and 2</a>.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia>The average Vbis was 34.88±7.81l, while the average Vw was 37.03±6.3l. The difference between the two volumes was 2.15l (p<0.01) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The agreement between VW and Vbis values was significant (r: −0.25, p<0.01).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Parameters were separated according to the difference between the 2V values: ≥10% or <10%. The difference between the two V values was ≥10%, in 58.67% of the measurements while in 41.33% of the measurements, the difference was <10%.Comparison of risk factors or clinical features between patients with or without difference in volumes revealed no significant difference in dyslipidemia (p=0.63), peripheral vascular disease (p=0.63), ischemic heart disease (p=0.96), ischemic neuropathy (0.93), antiaggregant/OCP (p=0.92), gender (p=0.69), age (p=0.18), peritoneal transport type (p=0.09) and type of PD (p=0.79). However, significant differences were found in the presence of hypertension (p<0.05), DM (p<0.05), hypoalbuminemia (p<0.01), hypoprealbuminemia (p<0.01), obesity (BMI) (p<0.05), excess of body fat (p<0.01), inflammation as measured by C reactive protein (CRP) (p<0.01), E/I high (p<0.01) decreased phase angle at 50Hz (p<0.01) and residual diuresis (p<0.05) (<a class="elsevierStyleCrossRefs" href="#tbl0015">Tables 3 and 4</a>).<elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia>DiscussionDetermination the V with the highest possible accuracy in PD patients is essential. Besides being necessary to determine the dialysis efficiency (Kt/V<a class="elsevierStyleCrossRef" href="#bib0065">13</a> equation), excess of volume is associated with inflammation,<a class="elsevierStyleCrossRef" href="#bib0070">14</a> malnutrition,<a class="elsevierStyleCrossRef" href="#bib0075">15</a> hypertension, ventricular hypertrophy,<a class="elsevierStyleCrossRefs" href="#bib0080">16,17</a> acardiovascular events<a class="elsevierStyleCrossRefs" href="#bib0090">18,19</a> and other pathological processes.<a class="elsevierStyleCrossRef" href="#bib0100">20</a> Therefore, finding the most objective way of measuring this volume in our patients is essential.Techniques commonly accepted as gold standard, such as deuterium dilution techniques are costly, complex or painful, and thus have limited applicability in everyday clinical practice. Measuring V with the Watson formula is seen as an easy and applicable method, this is why this method for calculating the body volume is widespread in dialysis centers.<a class="elsevierStyleCrossRefs" href="#bib0095">19,20</a> The avenue of BIS during the recent years has changed the method to assess hydration status in dialysis patients. BIS's theoretical advantage is that directly measure V and thus eliminates the error that may occur in anthropometric formula, to the point that it has been compared in several studies to gold standard methods in the measurement of V.<a class="elsevierStyleCrossRefs" href="#bib0100">20,21</a> It also provides important information about the patients’ distribution of body water and nutritional status. Therefore, at present, both ways of measuring V can be regarded as appropriate in clinical practice.The problem arises when both methods (Vbis and Vw) lead to considerable differences. Measuring the volume with the Watson formula should be simple, and results are applicable, at least, to the general population. However, PD patients have, by definition a different distribution of body water as compared to the general population and, in turn, they often have a number of clinical and pathological conditions that may contribute to the different distribution of V. These patients may benefit from measuring V with BIS and not with the Watson formula, which takes into account gender, age, weight and height, but is not influenced by the complex combination of factors present in PD patients.In the study conducted in our PD unit, first we observed, as in other studies, that the Watson formula overestimates V as compared with BIS<a class="elsevierStyleCrossRefs" href="#bib0110">22,23</a> measurement. We also found significant differences in some of the features of patients according to whether they had differences in V: hypertension, diabetes, residual diuresis, obesity (due to BMI and % of body fat), serum albumin/prealbuminemia, PCR, phase angle at 50Hz and E/I. Specifically, the difference between Vbis and Vw was greater than 10% in hypertensive, diabetic, obese (BMI≥30kg/m2 and body fat percentage ≥25% in men and 30% women), malnourished (albumin <3.5g/dl, prealbumin <25mg/dl and phase angle at 50Hz below average), swollen (PCR >5mg/l) patients and in patients without residual diuresis and E/I ratio greater than one, significantly.While assessing the reason why these patients show a difference between Vbis and Vw, it became evident that particularly diabetic<a class="elsevierStyleCrossRefs" href="#bib0120">24,25</a> patients, had a tendency for inflammation which causes a different distribution of body volume.The same can be applied to malnourished patients. Interestingly, regardless of the method used for evaluation, either prealbumin, or albumin (as nutritional marker, apart from morbidity and mortality marker) or the increasingly used phase angle at 50Hz for BIS<a class="elsevierStyleCrossRefs" href="#bib0130">26,27</a> in all cases the presence of poor nutrition generates differences between the two methods of assessing V. This is probably related to inflammation and the different distribution of body water.Something similar occurs in obese patients: excess of body mass due mainly to fat, but also to lean mass and, the tendency to fluid overload may interfere with the use of the formula for the calculation of V.<a class="elsevierStyleCrossRefs" href="#bib0140">28,29</a>The excess of volume, or the abnormal distribution in the body, is another factor causing the difference between Vbis and Vw. Considering residual diuresis, patients that maintain diuresis once initiated into the technique have better control fluids, which is beneficial. And patients with lees diuresis tend to be malnourished.<a class="elsevierStyleCrossRef" href="#bib0150">30</a> Therefore, it is not surprising that large differences between the two ways of measuring V arise in patients who have no diuresis, and worse management of body water.Something similar may occur in cases of hypoalbuminemia. It is well known that the loss of oncotic pressure caused by reduced serum proteins generates a redistribution of the intravascular volume with a tendency to edema and formation of “third space”. This is not accounted for by Watson formula,<a class="elsevierStyleCrossRef" href="#bib0155">31</a> which only takes into account the weight, age, height and sex, but does not consider<a class="elsevierStyleCrossRef" href="#bib0080">16</a> nutritional status or inflammation.The same happens with the high E/I ratio. A result >1 may be caused either by an excess of extracellular water, and therefore hyperhydration and edema, or by a lack of intracellular water, and thus low “total cell mass” and malnutrition or even the association of both.<a class="elsevierStyleCrossRef" href="#bib0160">32</a> In any case, the conclusion would be the same: different distribution of body volume and, therefore, a likely benefit from a direct measurement of V.We do not know whether in the general population differences in V would we seen and whether the previously described factors (hypertension, diabetes mellitus, hypoalbuminemia, hipoprealbuminemia, high CRP, obesity, decreased phase angle at 50Hz and high E/I), are applicable. In addition, it is unknown whether performing PD, is a necessary factor for these differences to appear.In conclusion, an accurate determination of V in PD patients is essential and therefore it is important to find the most appropriate method to measure it considering clinical and pathological conditions. According to our results, PD patients with hypertension, diabetics, without residual diuresis, obese, swollen and malnourished may benefit from the determination of V using BIS. The results presented here should be confirmed with studies using greater number of patients.FinancingThis study was partly supported by the BIOTYC Foundation (01/2011).Conflict of interestAll authors reported to have no conflict of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres821849" "titulo" => "Abstract" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Methods" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec818791" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres821848" "titulo" => "Resumen" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Métodos" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0050" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec818792" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Patients and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Financing" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflict of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-09-25" "fechaAceptado" => "2015-03-15" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec818791" "palabras" => array:4 [ 0 => "Peritoneal dialysis" 1 => "Bioimpedance spectroscopy" 2 => "Watson formula" 3 => "Total body volume" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec818792" "palabras" => array:4 [ 0 => "Diálisis peritoneal" 1 => "Bioimpedancia espectroscópica" 2 => "Fórmula de Watson" 3 => "Volumen corporal total" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "IntroductionKnowing total body volume (V) is crucial in patients on peritoneal dialysis (PD). It is usually calculated by the Watson anthropometric formula, although the use of bioimpedance spectroscopy (BIS) is becoming increasingly widespread. Measuring V with both methods can at times produce quite different results. ObjectiveWe aimed to identify differences between the 2 forms of measuring volume in a PD unit and determine which clinical factors are associated with these differences. MethodsOurs is an observational study of 74 patients on PD. We measured V using BIS (Vbis) and the Watson formula (Vw); 271 measurements were made with each method. We calculated the difference between Vbis and Vw in each patient and classified them into 2 groups: Difference between volumes ≥10% or <10% Vbis. We assessed the presence of several clinical parameters in our patients.We assessed whether there were any differences between Vbis and Vw (Student t-test). We determined whether there was any association between the difference in volumes and the presence of the clinical parameters analyzed (chi square test). ResultsV was 2.15 l higher measured by the Watson formula than with BIS (p<0.01). In 58.67% of the measurements, the difference between Vbis and Vw was ≥10%.Significant differences were found when comparing the presence of difference between volumes and the presence or not of diabetes mellitus (DM) (p=0.03), hypertension (HTN) (p=0.036), hypoalbuminemia (p<0.01), hypoprealbuminemia (p<0.01), low phase angle at 50Hz (p<0.01), high C reactive protein (p<0.01), obesity (p=0.027), E/I ratio (ratio between extracellular and intracellular water) ≥1 (p<0.01) and residual diuresis (p=0.029). ConclusionsThere are significant differences in the V of PD Unit patients when obtained by Watson formula or by BIS. A difference between the measurements is associated with the presence of DM, HTN, hypoalbuminaemia, obesity, malnutrition, inflammation, E/I ratio ≥1 and the absence of residual diuresis." "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Methods" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "IntroducciónConocer el volumen corporal total (V) es fundamental en los pacientes en diálisis peritoneal (DP). Habitualmente calculado mediante fórmula de Watson, el empleo de bioimpedancia espectroscópica (BIS), cada vez está más generalizado. Frecuentemente, al medir el V con ambos métodos surgen amplias diferencias. ObjetivoEvaluar si aparecen diferencias entre ambas formas de medir el V en una unidad de DP y analizar qué factores clínicos se asocian a estas diferencias. MétodosEstudio observacional. Se incluyó a 74 pacientes en DP. Medimos el V empleando BIS (Vbis) y fórmula de Watson (Vw); se recogieron 271 mediciones por cada método. Calculamos diferencia entre volúmenes en cada medición y los clasificamos en 2 grupos: diferencia ≥10% o <10% de Vbis. Evaluamos la presencia de una serie de parámetros clínicos en nuestros pacientes.Analizamos si existen diferencias entre Vbis y Vw (de Student). Valoramos si existe asociación entre las diferencias entre volúmenes y la presencia de los parámetros clínicos analizados (chi cuadrado). ResultadosEl Vbis fue 2,15 l mayor que Vw (p<0,01). El 58,67% de las mediciones tenían diferencia entre Vw y Vbis ≥10%. Aparecen diferencias significativas al comparar la presencia de diferencia entre volúmenes y la presencia o no de diabetes (p=0,03), hipertensión (p=0,036), hipoalbuminemia (p<0,01), hipoprealbuminemia (p<0,01), bajo ángulo de fase a 50Hz (p<0,01), proteína C reactiva elevada (p<0,01), obesidad (p=0,027), exceso de grasa corporal (p<0,01), E/I ratio (cociente entre agua extracelular y agua intracelular)≥1 (p<0,01) y diuresis residual (p=0,029). ConclusionesExisten diferencias en el V de los pacientes de una unidad de DP según sea calculado por fórmula de Watson o por BIS. La presencia de hipertensión, diabetes, hipoalbuminemia, obesidad, malnutrición, inflamación, E/I ratio ≥1 y la ausencia de diuresis residual se asocia con la aparición de estas diferencias." "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Métodos" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0050" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Fernández GM, Cerrato AO, de la Vara Iniesta L, Galera EO, Roldán CG, Martínez JP. Comparación entre bioimpedancia espectroscópica y fórmula de Watson para medición de volumen corporal en pacientes en diálisis peritoneal. Nefrologia. 2016;36:57–62." ] ] "multimedia" => array:5 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 931 "Ancho" => 1550 "Tamanyo" => 29059 ] ] "descripcion" => array:1 [ "en" => "Volume (l) calculated with the Watson formula (Vw) and BIS (Vbis) (p<0.01)." ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Percentage (%) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">HTA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">87.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dyslipidemia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Diabetes mellitus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Vascular disease (ABI) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">44.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ischemic heart disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ischemic neuropathy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Antiaggregant/OCP \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">44.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gender (male) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">56.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age ≥ 65 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">39.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Type PD (CAPD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">55.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1381841.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Risk factors present in analyzed patients." ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Percentage (%) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hypoalbuminemia (<3.5g/l) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">62 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Prealbumin <25mg/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Phase angle (50Hz) <4.3° \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">52 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">E/I (>1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Obesity (BMI≥30kg/m2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Body fat ≥25%/30% in male/female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Elevated CRP (>5mg/l) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Peritoneal transport (D/P Cr ≥0.65) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">50.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Overhydration (OH>1.1L) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">59 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Residual diuresis (>400cc/24h) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">58.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1381839.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Risk factors present in the measurements." ] ] 3 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Analyzed parameter \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">parameter% in a group with difference between V>10% \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">parameter% in a group with difference between V<10% \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Chi square (p) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">HTA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">90.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">81.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.036 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dyslipidemia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">64.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">61.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.63 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Diabetes mellitus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">42.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.03 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Vascular disease (ABI) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">52.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.63 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ischemic heart disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.96 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ischemic neuropathy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.93 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Antiaggregant/anticoagulation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">50.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.92 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gender (male) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">59.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">61.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.69 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age (over 65) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">49.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.18 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1381838.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Comparison of clinical, pathological and personal parameters and V differences (Chi square)." ] ] 4 => array:8 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at4" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Analyzed parameter \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">parameter% in group with difference between V>10% \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">parameter% in group with difference between V<10% \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Chi square (p) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Type of PD (CAPD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">56.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">58.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.79 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Peritoneal transport (PD/Cr≥0.65) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">45.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">71.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.09 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Residual diuresis (≥400cc) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">52.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">66.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.029 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Serum albumin (<3.5g/l) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">81.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.01 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Prealbumin (<25mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">52.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.01 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Phase angle at 50Hz (≥4.31°) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">62.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">49.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.01 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">E/I (≥1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">59.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.01 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Obesity (BMI≥30 kg/m2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.027 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">% of body fat (≥25% male or ≥30% female) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">77.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">53.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.01 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PCR (≥5mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">81 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.01 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1381840.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Comparison of nutritional and inflammatory parameters associated with dialysis and V differences (Chi square)." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:32 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guidelines of the Spanish Society of Nephrology. 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Comparación entre bioimpedancia espectroscópica y fórmula de Watson para medición de volumen corporal en pacientes en diálisis peritoneal

Gonzalo Martínez Fernándeza, Agustín Ortega Cerratoa, Lourdes de la Vara Iniestaa, Eva Oliver Galerab, Carmen Gómez Roldána, Juan Pérez Martíneza,

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gonzalomfer@hotmail.com
drjuanpm@gmail.com

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a Servicio de Nefrología, Complejo Hospitalario y Universitario de Albacete, Albacete, Spain

b Servicio de Medicina Interna, Complejo Hospitalario Universitario de Albacete, Galera (Albacete), Spain

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first&#44; to assess whether there are differences in <span class="elsevierStyleItalic">V</span> measurements in PD patients using BIS and an anthropometric formula &#40;Watson formula&#41;&#44; and second&#44; to assess which factors may influence the occurrence of these differences&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Patients and methods</span><p id="par0030" class="elsevierStylePara elsevierViewall">We conducted a prospective observational study involving 74 PD patients&#44; 42 males &#40;56&#46;76&#37;&#41; and 32 females &#40;43&#46;24&#37;&#41; with an average age of 59&#44; 98<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#44; 96 &#40;range 24&#46;13 and 82&#46;98 years&#41;&#46; The causes of renal failure were diabetic nephropathy &#40;25&#46;68&#37;&#41;&#44; followed by chronic tubulointerstitial nephropathy &#40;22&#46;97&#37;&#41;&#44; chronic glomerulonephritis &#40;18&#46;92&#37;&#41;&#44; nephrosclerosis &#40;12&#46;16&#37;&#41;&#44; hepatorenal polycystic disease &#40;6&#46;76&#37;&#41; and ischemic nephropathy &#40;2&#46;70&#37;&#41;&#44; while the etiology was unknown in 10&#46;81&#37;&#46; Continuous ambulatory peritoneal dialysis &#40;CAPD&#41; was used in 41 patients &#40;55&#46;41&#37;&#41;&#44; while automated peritoneal dialysis &#40;APD&#41; was used in 33 &#40;44&#46;59&#37;&#41;&#46; According to the peritoneal transport as measured by D&#47;P creatinine&#44; 47&#46;97&#37; were in the medium-low average transport&#44; 47&#46;60 in the medium-high&#44; 2&#46;58&#37; in the high and 1&#46;85&#37; in the low&#46; The criteria to apply CAPD or APD was the patient&#39;s personal choice&#46; Exclusion criteria for this study were the unability to perform the BIS test accurately&#58; presence of major amputations and being a carrier of metal components such as stents&#44; pacemakers&#44; prosthetic joints or defibrillators&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Values of height and weight were obtained in each patient and a measurement of body volume by BIS &#40;Body Composition Monitor&#58; Fresenius Medical Care&#41; for total body volume &#40;Vbis&#41; was performed&#46; Also a measurement of hydration&#44; extracellular water&#44; intracellular water and E&#47;I ratio was carried out&#46; BIS was performed after fasting&#44; without di&#225;lisis<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> solution in the abdomen and with an empty bladder in those patients who maintained residual kidney function&#46; The body volume was also calculated using the standard Watson equation &#40;Vw&#41; &#40;men&#58; <span class="elsevierStyleItalic">V</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;447<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>&#40;0&#46;09156<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>age&#41;<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>&#40;0&#46;1074<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>height&#41;<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>&#40;0&#46;3362<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>weight&#41;&#59; women&#58; <span class="elsevierStyleItalic">V</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#40;0&#46;1096<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>height&#41;<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>&#40;0&#46;2466<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>weight&#41;<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>2&#46;097&#41;&#46; Once the volume was obtained by both methods&#44; patients were separated into two groups according to the difference obtained using the two methods&#58; &#8805;10&#37; or &#60;10&#37; of Vbis &#40;these percentages are above the standard error of <span class="elsevierStyleItalic">V</span> measurements using BIS&#44; which is estimated at 5&#37;&#44;&#41;&#46; In total&#44; we have 271 volume measurements from the 74 patients previously described&#46; The volumes are expressed as arithmetic mean plus standard deviation&#46; Student t test was used to analyze whether the difference between Vbis and Vw was significant&#46; In turn&#44; we performed a Bland Altman test to evaluate the correlation between the 2 methods&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">In each patient&#44; a number of features considered potentially responsible for generating differences between volumes were recorded&#46;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0045" class="elsevierStylePara elsevierViewall">Personal parameters&#58; age &#40;&#8805;65 or &#60;65 years&#41; and sex &#40;male or female&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0050" class="elsevierStylePara elsevierViewall">Clinical and pathological parameters&#58; presence or absence of hypertension &#40;defined as taking at least 2 antihypertensive drugs&#41;&#44; dyslipidemia&#44; diabetes mellitus &#40;DM&#41;&#44; ischemic heart disease&#44; neuropathy&#44; peripheral vascular disease measured by ankle-brachial index and the use of antiplatelets aggregation agents or anticoagulants&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">-</span><p id="par0055" class="elsevierStylePara elsevierViewall">Parameters associated with dialysis&#58; type of PD &#40;CAPD or APD&#41;&#44; peritoneal transport &#40;D&#47;P Cr &#8805;0&#46;65 or &#60;0&#46;65&#41; and presence of residual diuresis &#40;defined as greater than or equal to 400<span class="elsevierStyleHsp" style=""></span>cc&#47;24<span class="elsevierStyleHsp" style=""></span>h&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">-</span><p id="par0060" class="elsevierStylePara elsevierViewall">Nutritional and inflammatory parameters&#58; E&#47;I ratio measured by BIS &#40;&#8805;1 or &#60;1&#41;&#44; obesity &#40;BMI &#8805;30 or &#60;30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&#44; &#37; of body fat by BIS &#40;&#8805;25 or &#60;25&#37; in men and 30&#37; in women&#41;&#44; prealbumin &#40;&#8805;25 or &#60;25<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&#44; hypoalbuminemia &#40;serum albumin &#8805;3&#46;5 or &#60;3&#46;5<span class="elsevierStyleHsp" style=""></span>g&#47;dl&#41;&#44; phase angle at 50<span class="elsevierStyleHsp" style=""></span>Hz &#40;greater or lower than average phase angle at 50<span class="elsevierStyleHsp" style=""></span>Hz obtained in all analyzed patients&#58; 4&#46;31&#176;&#41; and CRP &#40;&#8805;5 or &#60;5<span class="elsevierStyleHsp" style=""></span>mg&#47;l&#41;&#46;</p></li></ul></p><p id="par0065" class="elsevierStylePara elsevierViewall">Subsequently&#44; we used the chi-square test to assess whether there is an association between the differences in volume and the presence or absence of the described clinical parameters&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">All statistical tests &#40;Student t test&#44; Bland Altman test and chi square test&#41; were performed by using SPSS 15&#46;0 for Windows&#44; being <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 considered as significant&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="par0075" class="elsevierStylePara elsevierViewall">We assessed the presence or absence of a number of factors and clinical parameters in patients and in the way measurements were carried out&#46; This information is shown in <a class="elsevierStyleCrossRefs" href="#tbl0005">Tables 1 and 2</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">The average Vbis was 34&#46;88<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;81<span class="elsevierStyleHsp" style=""></span>l&#44; while the average Vw was 37&#46;03<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;3<span class="elsevierStyleHsp" style=""></span>l&#46; The difference between the two volumes was 2&#46;15<span class="elsevierStyleHsp" style=""></span>l &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; The agreement between VW and Vbis values was significant &#40;<span class="elsevierStyleItalic">r</span>&#58; &#8722;0&#46;25&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Parameters were separated according to the difference between the 2<span class="elsevierStyleHsp" style=""></span>V values&#58; &#8805;10&#37; or &#60;10&#37;&#46; The difference between the two <span class="elsevierStyleItalic">V</span> values was &#8805;10&#37;&#44; in 58&#46;67&#37; of the measurements while in 41&#46;33&#37; of the measurements&#44; the difference was &#60;10&#37;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Comparison of risk factors or clinical features between patients with or without difference in volumes revealed no significant difference in dyslipidemia &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;63&#41;&#44; peripheral vascular disease &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;63&#41;&#44; ischemic heart disease &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;96&#41;&#44; ischemic neuropathy &#40;0&#46;93&#41;&#44; antiaggregant&#47;OCP &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;92&#41;&#44; gender &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;69&#41;&#44; age &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;18&#41;&#44; peritoneal transport type &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;09&#41; and type of PD &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;79&#41;&#46; However&#44; significant differences were found in the presence of hypertension &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#44; DM &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#44; hypoalbuminemia &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#44; hypoprealbuminemia &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#44; obesity &#40;BMI&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#44; excess of body fat &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#44; inflammation as measured by C reactive protein &#40;CRP&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#44; E&#47;I high &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41; decreased phase angle at 50<span class="elsevierStyleHsp" style=""></span>Hz &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41; and residual diuresis &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41; &#40;<a class="elsevierStyleCrossRefs" href="#tbl0015">Tables 3 and 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discussion</span><p id="par0095" class="elsevierStylePara elsevierViewall">Determination the <span class="elsevierStyleItalic">V</span> with the highest possible accuracy in PD patients is essential&#46; Besides being necessary to determine the dialysis efficiency &#40;Kt&#47;<span class="elsevierStyleItalic">V</span><a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> equation&#41;&#44; excess of volume is associated with inflammation&#44;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> malnutrition&#44;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> hypertension&#44; ventricular hypertrophy&#44;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16&#44;17</span></a> acardiovascular events<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18&#44;19</span></a> and other pathological processes&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> Therefore&#44; finding the most objective way of measuring this volume in our patients is essential&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Techniques commonly accepted as <span class="elsevierStyleItalic">gold standard</span>&#44; such as deuterium dilution techniques are costly&#44; complex or painful&#44; and thus have limited applicability in everyday clinical practice&#46; Measuring <span class="elsevierStyleItalic">V</span> with the Watson formula is seen as an easy and applicable method&#44; this is why this method for calculating the body volume is widespread in dialysis centers&#46;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19&#44;20</span></a> The avenue of BIS during the recent years has changed the method to assess hydration status in dialysis patients&#46; BIS&#39;s theoretical advantage is that directly measure <span class="elsevierStyleItalic">V</span> and thus eliminates the error that may occur in anthropometric formula&#44; to the point that it has been compared in several studies to <span class="elsevierStyleItalic">gold standard</span> methods in the measurement of <span class="elsevierStyleItalic">V</span>&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#44;21</span></a> It also provides important information about the patients&#8217; distribution of body water and nutritional status&#46; Therefore&#44; at present&#44; both ways of measuring <span class="elsevierStyleItalic">V</span> can be regarded as appropriate in clinical practice&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The problem arises when both methods &#40;Vbis and Vw&#41; lead to considerable differences&#46; Measuring the volume with the Watson formula should be simple&#44; and results are applicable&#44; at least&#44; to the general population&#46; However&#44; PD patients have&#44; by definition a different distribution of body water as compared to the general population and&#44; in turn&#44; they often have a number of clinical and pathological conditions that may contribute to the different distribution of <span class="elsevierStyleItalic">V</span>&#46; These patients may benefit from measuring <span class="elsevierStyleItalic">V</span> with BIS and not with the Watson formula&#44; which takes into account gender&#44; age&#44; weight and height&#44; but is not influenced by the complex combination of factors present in PD patients&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">In the study conducted in our PD unit&#44; first we observed&#44; as in other studies&#44; that the Watson formula overestimates <span class="elsevierStyleItalic">V</span> as compared with BIS<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">22&#44;23</span></a> measurement&#46; We also found significant differences in some of the features of patients according to whether they had differences in <span class="elsevierStyleItalic">V</span>&#58; hypertension&#44; diabetes&#44; residual diuresis&#44; obesity &#40;due to BMI and &#37; of body fat&#41;&#44; serum albumin&#47;prealbuminemia&#44; PCR&#44; phase angle at 50<span class="elsevierStyleHsp" style=""></span>Hz and E&#47;I&#46; Specifically&#44; the difference between Vbis and Vw was greater than 10&#37; in hypertensive&#44; diabetic&#44; obese &#40;BMI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> and body fat percentage &#8805;25&#37; in men and 30&#37; women&#41;&#44; malnourished &#40;albumin &#60;3&#46;5<span class="elsevierStyleHsp" style=""></span>g&#47;dl&#44; prealbumin &#60;25<span class="elsevierStyleHsp" style=""></span>mg&#47;dl and phase angle at 50<span class="elsevierStyleHsp" style=""></span>Hz below average&#41;&#44; swollen &#40;PCR &#62;5<span class="elsevierStyleHsp" style=""></span>mg&#47;l&#41; patients and in patients without residual diuresis and E&#47;I ratio greater than one&#44; significantly&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">While assessing the reason why these patients show a difference between Vbis and Vw&#44; it became evident that particularly diabetic<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">24&#44;25</span></a> patients&#44; had a tendency for inflammation which causes a different distribution of body volume&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">The same can be applied to malnourished patients&#46; Interestingly&#44; regardless of the method used for evaluation&#44; either prealbumin&#44; or albumin &#40;as nutritional marker&#44; apart from morbidity and mortality marker&#41; or the increasingly used phase angle at 50<span class="elsevierStyleHsp" style=""></span>Hz for BIS<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">26&#44;27</span></a> in all cases the presence of poor nutrition generates differences between the two methods of assessing <span class="elsevierStyleItalic">V</span>&#46; This is probably related to inflammation and the different distribution of body water&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Something similar occurs in obese patients&#58; excess of body mass due mainly to fat&#44; but also to lean mass and&#44; the tendency to fluid overload may interfere with the use of the formula for the calculation of <span class="elsevierStyleItalic">V</span>&#46;<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">28&#44;29</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">The excess of volume&#44; or the abnormal distribution in the body&#44; is another factor causing the difference between Vbis and Vw&#46; Considering residual diuresis&#44; patients that maintain diuresis once initiated into the technique have better control fluids&#44; which is beneficial&#46; And patients with lees diuresis tend to be malnourished&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> Therefore&#44; it is not surprising that large differences between the two ways of measuring <span class="elsevierStyleItalic">V</span> arise in patients who have no diuresis&#44; and worse management of body water&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Something similar may occur in cases of hypoalbuminemia&#46; It is well known that the loss of oncotic pressure caused by reduced serum proteins generates a redistribution of the intravascular volume with a tendency to edema and formation of &#8220;third space&#8221;&#46; This is not accounted for by Watson formula&#44;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a> which only takes into account the weight&#44; age&#44; height and sex&#44; but does not consider<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> nutritional status or inflammation&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">The same happens with the high E&#47;I ratio&#46; A result &#62;1 may be caused either by an excess of extracellular water&#44; and therefore hyperhydration and edema&#44; or by a lack of intracellular water&#44; and thus low &#8220;total cell mass&#8221; and malnutrition or even the association of both&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a> In any case&#44; the conclusion would be the same&#58; different distribution of body volume and&#44; therefore&#44; a likely benefit from a direct measurement of <span class="elsevierStyleItalic">V</span>&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">We do not know whether in the general population differences in <span class="elsevierStyleItalic">V</span> would we seen and whether the previously described factors &#40;hypertension&#44; diabetes mellitus&#44; hypoalbuminemia&#44; hipoprealbuminemia&#44; high CRP&#44; obesity&#44; decreased phase angle at 50<span class="elsevierStyleHsp" style=""></span>Hz and high E&#47;I&#41;&#44; are applicable&#46; In addition&#44; it is unknown whether performing PD&#44; is a necessary factor for these differences to appear&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">In conclusion&#44; an accurate determination of <span class="elsevierStyleItalic">V</span> in PD patients is essential and therefore it is important to find the most appropriate method to measure it considering clinical and pathological conditions&#46; According to our results&#44; PD patients with hypertension&#44; diabetics&#44; without residual diuresis&#44; obese&#44; swollen and malnourished may benefit from the determination of <span class="elsevierStyleItalic">V</span> using BIS&#46; The results presented here should be confirmed with studies using greater number of patients&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Financing</span><p id="par0155" class="elsevierStylePara elsevierViewall">This study was partly supported by the <span class="elsevierStyleGrantSponsor" id="gs1">BIOTYC Foundation</span> &#40;01&#47;2011&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflict of interest</span><p id="par0160" class="elsevierStylePara elsevierViewall">All authors reported to have no conflict of interest&#46;</p></span></span>"
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    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2014-09-25"
    "fechaAceptado" => "2015-03-15"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec818791"
          "palabras" => array:4 [
            0 => "Peritoneal dialysis"
            1 => "Bioimpedance spectroscopy"
            2 => "Watson formula"
            3 => "Total body volume"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec818792"
          "palabras" => array:4 [
            0 => "Di&#225;lisis peritoneal"
            1 => "Bioimpedancia espectrosc&#243;pica"
            2 => "F&#243;rmula de Watson"
            3 => "Volumen corporal total"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Knowing total body volume &#40;<span class="elsevierStyleItalic">V</span>&#41; is crucial in patients on peritoneal dialysis &#40;PD&#41;&#46; It is usually calculated by the Watson anthropometric formula&#44; although the use of bioimpedance spectroscopy &#40;BIS&#41; is becoming increasingly widespread&#46; Measuring <span class="elsevierStyleItalic">V</span> with both methods can at times produce quite different results&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objective</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We aimed to identify differences between the 2 forms of measuring volume in a PD unit and determine which clinical factors are associated with these differences&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Ours is an observational study of 74 patients on PD&#46; We measured <span class="elsevierStyleItalic">V</span> using BIS &#40;Vbis&#41; and the Watson formula &#40;Vw&#41;&#59; 271 measurements were made with each method&#46; We calculated the difference between Vbis and Vw in each patient and classified them into 2 groups&#58; Difference between volumes &#8805;10&#37; or &#60;10&#37; Vbis&#46; We assessed the presence of several clinical parameters in our patients&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">We assessed whether there were any differences between Vbis and Vw &#40;Student <span class="elsevierStyleItalic">t</span>-test&#41;&#46; We determined whether there was any association between the difference in volumes and the presence of the clinical parameters analyzed &#40;chi square test&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">V</span> was 2&#46;15 l higher measured by the Watson formula than with BIS &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#60;</span><span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#46; In 58&#46;67&#37; of the measurements&#44; the difference between Vbis and Vw was &#8805;10&#37;&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Significant differences were found when comparing the presence of difference between volumes and the presence or not of diabetes mellitus &#40;DM&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;03&#41;&#44; hypertension &#40;HTN&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;036&#41;&#44; hypoalbuminemia &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#44; hypoprealbuminemia &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#44; low phase angle at 50<span class="elsevierStyleHsp" style=""></span>Hz &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#44; high C reactive protein &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#44; obesity &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;027&#41;&#44; E&#47;I ratio &#40;ratio between extracellular and intracellular water&#41; &#8805;1 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41; and residual diuresis &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;029&#41;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">There are significant differences in the <span class="elsevierStyleItalic">V</span> of PD Unit patients when obtained by Watson formula or by BIS&#46; A difference between the measurements is associated with the presence of DM&#44; HTN&#44; hypoalbuminaemia&#44; obesity&#44; malnutrition&#44; inflammation&#44; E&#47;I ratio &#8805;1 and the absence of residual diuresis&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Objective"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Methods"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Results"
          ]
          4 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Conclusions"
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      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introducci&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Conocer el volumen corporal total &#40;V&#41; es fundamental en los pacientes en di&#225;lisis peritoneal &#40;DP&#41;&#46; Habitualmente calculado mediante f&#243;rmula de Watson&#44; el empleo de bioimpedancia espectrosc&#243;pica &#40;BIS&#41;&#44; cada vez est&#225; m&#225;s generalizado&#46; Frecuentemente&#44; al medir el V con ambos m&#233;todos surgen amplias diferencias&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivo</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Evaluar si aparecen diferencias entre ambas formas de medir el V en una unidad de DP y analizar qu&#233; factores cl&#237;nicos se asocian a estas diferencias&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todos</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional&#46; Se incluy&#243; a 74 pacientes en DP&#46; Medimos el V empleando BIS &#40;Vbis&#41; y f&#243;rmula de Watson &#40;Vw&#41;&#59; se recogieron 271 mediciones por cada m&#233;todo&#46; Calculamos diferencia entre vol&#250;menes en cada medici&#243;n y los clasificamos en 2 grupos&#58; diferencia &#8805;10&#37; o &#60;10&#37; de Vbis&#46; Evaluamos la presencia de una serie de par&#225;metros cl&#237;nicos en nuestros pacientes&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Analizamos si existen diferencias entre Vbis y Vw &#40;de Student&#41;&#46; Valoramos si existe asociaci&#243;n entre las diferencias entre vol&#250;menes y la presencia de los par&#225;metros cl&#237;nicos analizados &#40;chi cuadrado&#41;&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">El Vbis fue 2&#44;15 l mayor que Vw &#40;p<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#60;</span><span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46; El 58&#44;67&#37; de las mediciones ten&#237;an diferencia entre Vw y Vbis &#8805;10&#37;&#46; Aparecen diferencias significativas al comparar la presencia de diferencia entre vol&#250;menes y la presencia o no de diabetes &#40;p<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#61;</span><span class="elsevierStyleHsp" style=""></span>0&#44;03&#41;&#44; hipertensi&#243;n &#40;p<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#61;</span><span class="elsevierStyleHsp" style=""></span>0&#44;036&#41;&#44; hipoalbuminemia &#40;p<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#60;</span><span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; hipoprealbuminemia &#40;p<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#60;</span><span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; bajo &#225;ngulo de fase a 50<span class="elsevierStyleHsp" style=""></span>Hz &#40;p<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#60;</span><span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; prote&#237;na C reactiva elevada &#40;p<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#60;</span><span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; obesidad &#40;p<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#61;</span><span class="elsevierStyleHsp" style=""></span>0&#44;027&#41;&#44; exceso de grasa corporal &#40;p<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#60;</span><span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; E&#47;I ratio &#40;cociente entre agua extracelular y agua intracelular&#41;&#8805;1 &#40;p<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#60;</span><span class="elsevierStyleHsp" style=""></span>0&#44;01&#41; y diuresis residual &#40;p<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#61;</span><span class="elsevierStyleHsp" style=""></span>0&#44;029&#41;&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusiones</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Existen diferencias en el V de los pacientes de una unidad de DP seg&#250;n sea calculado por f&#243;rmula de Watson o por BIS&#46; La presencia de hipertensi&#243;n&#44; diabetes&#44; hipoalbuminemia&#44; obesidad&#44; malnutrici&#243;n&#44; inflamaci&#243;n&#44; E&#47;I ratio &#8805;1 y la ausencia de diuresis residual se asocia con la aparici&#243;n de estas diferencias&#46;</p></span>"
        "secciones" => array:5 [
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            "identificador" => "abst0030"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Objetivo"
          ]
          2 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "M&#233;todos"
          ]
          3 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Resultados"
          ]
          4 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Fern&#225;ndez GM&#44; Cerrato AO&#44; de la Vara Iniesta L&#44; Galera EO&#44; Rold&#225;n CG&#44; Mart&#237;nez JP&#46; Comparaci&#243;n entre bioimpedancia espectrosc&#243;pica y f&#243;rmula de Watson para medici&#243;n de volumen corporal en pacientes en di&#225;lisis peritoneal&#46; Nefrologia&#46; 2016&#59;36&#58;57&#8211;62&#46;</p>"
      ]
    ]
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      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 931
            "Ancho" => 1550
            "Tamanyo" => 29059
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Volume &#40;l&#41; calculated with the Watson formula &#40;Vw&#41; and BIS &#40;Vbis&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#46;</p>"
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        "etiqueta" => "Table 1"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Percentage &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">HTA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dyslipidemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Diabetes mellitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Vascular disease &#40;ABI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ischemic heart disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ischemic neuropathy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Antiaggregant&#47;OCP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gender &#40;male&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age &#8805; 65 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Type PD &#40;CAPD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Risk factors present in analyzed patients&#46;</p>"
        ]
      ]
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        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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        "detalles" => array:1 [
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            "identificador" => "at2"
            "detalle" => "Table "
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        ]
        "tabla" => array:1 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Percentage &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hypoalbuminemia &#40;&#60;3&#46;5<span class="elsevierStyleHsp" style=""></span>g&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Prealbumin &#60;25<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Phase angle &#40;50<span class="elsevierStyleHsp" style=""></span>Hz&#41; &#60;4&#46;3&#176;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">E&#47;I &#40;&#62;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Obesity &#40;BMI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Body fat &#8805;25&#37;&#47;30&#37; in male&#47;female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Elevated CRP &#40;&#62;5<span class="elsevierStyleHsp" style=""></span>mg&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Peritoneal transport &#40;D&#47;P Cr &#8805;0&#46;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Overhydration &#40;OH<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>1&#46;1<span class="elsevierStyleHsp" style=""></span>L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Residual diuresis &#40;&#62;400<span class="elsevierStyleHsp" style=""></span>cc&#47;24<span class="elsevierStyleHsp" style=""></span>h&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Risk factors present in the measurements&#46;</p>"
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      3 => array:8 [
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          0 => array:3 [
            "identificador" => "at3"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Analyzed parameter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">parameter&#37; in a group with difference between <span class="elsevierStyleItalic">V</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>10&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">parameter&#37; in a group with difference between <span class="elsevierStyleItalic">V</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>10&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Chi square &#40;<span class="elsevierStyleItalic">p</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">HTA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">90&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">81&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;036&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dyslipidemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Diabetes mellitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Vascular disease &#40;ABI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ischemic heart disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ischemic neuropathy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Antiaggregant&#47;anticoagulation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gender &#40;male&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age &#40;over 65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Analyzed parameter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">parameter&#37; in group with difference between <span class="elsevierStyleItalic">V</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>10&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">parameter&#37; in group with difference between <span class="elsevierStyleItalic">V</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>10&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Chi square &#40;<span class="elsevierStyleItalic">p</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Type of PD &#40;CAPD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Peritoneal transport &#40;PD&#47;Cr<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>0&#46;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">71&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Residual diuresis &#40;&#8805;400<span class="elsevierStyleHsp" style=""></span>cc&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;029&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Serum albumin &#40;&#60;3&#46;5<span class="elsevierStyleHsp" style=""></span>g&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">81&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Prealbumin &#40;&#60;25<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Phase angle at 50<span class="elsevierStyleHsp" style=""></span>Hz &#40;&#8805;4&#46;31&#176;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">E&#47;I &#40;&#8805;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Obesity &#40;BMI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>30 kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;027&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#37; of body fat &#40;&#8805;25&#37; male or &#8805;30&#37; female&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">77&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PCR &#40;&#8805;5<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Comparison of nutritional and inflammatory parameters associated with dialysis and <span class="elsevierStyleItalic">V</span> differences &#40;Chi square&#41;&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:32 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines of the Spanish Society of Nephrology&#46; Clinical practice guidelines for peritoneal"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Arrieta"
                            1 => "M&#46;A&#46; Bajo"
                            2 => "F&#46; Caravaca"
                            3 => "F&#46; Coronel"
                            4 => "H&#46; Garc&#237;a-P&#233;rez"
                            5 => "E&#46; Gonz&#225;lez-Parra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Nefrolog&#237;a"
                        "fecha" => "2006"
                        "volumen" => "26"
                        "paginaInicial" => "1"
                        "paginaFinal" => "184"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17806214"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Total body water volumes for adult males and females estimated from simple anthropometric measurements"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46;E&#46; Watson"
                            1 => "I&#46;D&#46; Watson"
                            2 => "R&#46;D&#46; Batt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Clin Nutr"
                        "fecha" => "1980"
                        "volumen" => "33"
                        "paginaInicial" => "27"
                        "paginaFinal" => "39"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6986753"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
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Article information

ISSN: 20132514
Original language: English

DOI:10.1016/j.nefroe.2016.02.002

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Year/Month	Html	Pdf	Total

2024 November	9	8	17
2024 October	26	45	71
2024 September	41	33	74
2024 August	47	39	86
2024 July	75	29	104
2024 June	53	38	91
2024 May	62	40	102
2024 April	55	25	80
2024 March	46	28	74
2024 February	35	42	77
2024 January	51	23	74
2023 December	46	24	70
2023 November	51	34	85
2023 October	57	24	81
2023 September	46	26	72
2023 August	43	36	79
2023 July	39	24	63
2023 June	37	13	50
2023 May	50	31	81
2023 April	25	11	36
2023 March	52	21	73
2023 February	36	21	57
2023 January	36	33	69
2022 December	52	23	75
2022 November	61	33	94
2022 October	40	44	84
2022 September	36	26	62
2022 August	68	53	121
2022 July	57	42	99
2022 June	39	32	71
2022 May	46	36	82
2022 April	49	45	94
2022 March	55	47	102
2022 February	36	53	89
2022 January	41	29	70
2021 December	43	38	81
2021 November	35	35	70
2021 October	52	43	95
2021 September	37	39	76
2021 August	25	35	60
2021 July	39	38	77
2021 June	19	21	40
2021 May	36	30	66
2021 April	68	52	120
2021 March	55	26	81
2021 February	44	16	60
2021 January	49	20	69
2020 December	40	12	52
2020 November	48	20	68
2020 October	40	24	64
2020 September	51	9	60
2020 August	48	18	66
2020 July	34	7	41
2020 June	53	12	65
2020 May	58	9	67
2020 April	42	13	55
2020 March	52	12	64
2020 February	63	21	84
2020 January	69	17	86
2019 December	66	15	81
2019 November	60	17	77
2019 October	46	14	60
2019 September	51	17	68
2019 August	41	14	55
2019 July	34	18	52
2019 June	47	20	67
2019 May	37	13	50
2019 April	69	34	103
2019 March	37	20	57
2019 February	45	31	76
2019 January	21	24	45
2018 December	120	54	174
2018 November	166	19	185
2018 October	45	24	69
2018 September	48	14	62
2018 August	39	20	59
2018 July	37	14	51
2018 June	36	17	53
2018 May	36	12	48
2018 April	44	6	50
2018 March	54	6	60
2018 February	41	9	50
2018 January	51	5	56
2017 December	56	12	68
2017 November	64	10	74
2017 October	36	10	46
2017 September	31	8	39
2017 August	25	8	33
2017 July	27	12	39
2017 June	41	11	52
2017 May	50	11	61
2017 April	37	12	49
2017 March	21	16	37
2017 February	28	9	37
2017 January	19	3	22
2016 December	30	3	33
2016 November	56	15	71
2016 October	74	6	80
2016 September	102	3	105
2016 August	113	4	117
2016 July	172	7	179
2016 June	114	0	114
2016 May	170	0	170
2016 April	98	0	98

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