Bolte, LilianIbacache, María JoséDelgado, IrisCano, Francisco2022-07-112022-07-112019Bolte L, Ibacache MJ, Delgado I, Cano F. Free Water Transport and its Association with Cardiovascular Status in Children on Peritoneal Dialysis. Peritoneal Dialysis International. 2019;39(4):323-329. doi:10.3747/pdi.2018.00113https://doi.org/10.3747/pdi.2018.00113http://hdl.handle.net/11447/6351Background:Volume overload is one of the most important factors associated with left ventricular hypertrophy (LVH) and cardiovascular disease in chronic peritoneal dialysis (PD) patients. MiniPET is a reliable tool to evaluate free water transport (FWT). In a clinical setting, the significance of FWT has not been evaluated in terms of outcome in children on PD. The objective was to define a FWT value of clinical significance in children on PD, fixing its relationship to left ventricular mass index (LVMI) as a well-known outcome parameter.Methods:MiniPET was performed with 3.86% glucose, 1-h long, to measure FWT in PD patients > 6 years old. An echocardiogram (ECG) was performed within 2 months of the MiniPET. Left ventricular hypertrophy was defined as LVMI ≥ 38.6 g/height2.7 (95th percentile). Receiver operating characteristic curve (ROC) analysis was used to determine the cut-off value of FWT searching the highest sensitivity and specificity to differentiate patients with normal/abnormal LVMI. A p < 0.05 was considered significant.Results:Forty-six studies were performed on 32 patients, 16 males; mean age 11.59 ± 3.07 years. Mean normalized FWT (nFWT) was 144.4 ± 84.8 mL/m2, corresponding to 46.7% of total ultrafiltration. Mean LVMI was 42 ± 11.3 g/m2.7 with a negative correlation to nFWT (p < 0.01). Eighteen out of 32 patients had LVH. The ROC analysis (nFWT vs LVMI) showed an area under the curve of 0.71 (95% confidence interval [CI], 0.53 - 0.89; p = 0.04), allowing a cut-off nFWT value of 110 mL/m2 to be defined, dividing the population into 2 groups of patients according to the LVMI cut-off value of 38,6 g/m2.7.Conclusions:The nFWT showed an inverse correlation to LVMI. A nFWT value < 110 mL/m2 was significantly associated with LVH. The negative relationship observed between nFWT and LVMI, and the cut-off level for nFWT according to the 95th percentile of LVMI, suggest that the regular evaluation of nFWT could become a useful tool in assessing the capacity of PD treatment to keep patients' volume status under control, avoiding cardiovascular impairment.enMiniPETAdequacyLeft ventricular hypertrophyFree Water Transport and Its Association with Cardiovascular Status in Children on Peritoneal DialysisArticle