Fluid Overload in Peritoneal Dialysis Patients

Volume management in peritoneal dialysis patients is of importance, as both volume overload and dehydration are associated with worse outcomes. When assessing volume status, it is important to understand that different techniques measure different fluid compartments (intracellular vs extracellular vs circulating volume) and the impact of cardiac function. Attention to salt restriction and diuretics can help to maintain euvolemia without need for hypertonic bags. Glycaemia should be monitored to avoid thirst. Dwell length should be adapted to transport status: short dwells for fast transporters, long dwells in slow transporters. The role of bio-compatible solutions on volume control remains controversial.