Maintenance Notice

Due to necessary scheduled maintenance, the JMIR Publications website will be unavailable from Monday, March 11, 2019 at 4:00 PM to 4:30 PM EST. We apologize in advance for any inconvenience this may cause you.

Who will be affected?

Advertisement

Currently submitted to: JMIR mHealth and uHealth

Date Submitted: Jun 4, 2019
Open Peer Review Period: Jun 7, 2019 - Aug 2, 2019
(closed for review but you can still tweet)

NOTE: This is an unreviewed Preprint

Warning: This is a unreviewed preprint (What is a preprint?). Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn (a note “no longer under consideration” will appear above).

Peer-review me: Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period (in this case, a “Peer-Review Me” button to sign up as reviewer is displayed above). All preprints currently open for review are listed here. Outside of the formal open peer-review period we encourage you to tweet about the preprint.

Citation: Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author).

Final version: If our system detects a final peer-reviewed “version of record” (VoR) published in any journal, a link to that VoR will appear below. Readers are then encourage to cite the VoR instead of this preprint.

Settings: If you are the author, you can login and change the preprint display settings, but the preprint URL/DOI is supposed to be stable and citable, so it should not be removed once posted.

Submit: To post your own preprint, simply submit to any JMIR journal, and choose the appropriate settings to expose your submitted version as preprint.

An App Predicting Peritoneal Dialysis Appropriate Dwell Volume for Patients in Daily Practice

  • Hsien-Yi Wang; 
  • Wei-Chih Kan; 
  • Chih-Chiang Chien; 
  • Tsair-Wei Chien

Background:

Few studies mention how to objectively adjust peritoneal dialysis (PD) dwell volume (DV) for adult continuous ambulatory peritoneal dialysis patients. It requires a great deal of physicians’ precious time to determine the appropriate DV during daily practice. An app with evidence is required to solve this problem independently and efficiently.

Objective:

This study aims to determine a method for fluid control that can reduce fluid overload-related complications. We proposed a reference equation composed of parameters from the peritoneal equilibration test (PET) for adjusting daily dialysate DV to obtain more ultrafiltration volume.

Methods:

Ninety PD patients being treated at one medical center were enrolled, with laboratory data collected during half-yearly PET evaluations. The instilled dialysate was composed of 2.57% glucose PD fluid, either 1500 ml or 2000 ml for two groups in DV. We measured intraperitoneal pressure (IPP) before dialysate instilled (P0) and drained in the supine position after four hours (P4), effluent volume (ml), body mass index (BMI), waist circumference, and other parameters, including social demographics, to predict the appropriate DV. Exploratory factor analysis (EFA) was performed to extract independent domains. Statistical multivariate techniques of discrimination analysis and logistic regression (LR) to verify the most feasible and optimal formula were applied to determine infill volumes for patients. A final equation for fine-tuning daily DV was proposed with an app to be used for physicians and patients in clinical settings.

Results:

Two domains were observed by using EFA: (1) P0, and P4, and effluent volume and (2) BMI and wais circumference. We determined a formula for calculating daily dialysate DV, derived from L to obtain an accurate prediction rate of 94.44% higher than the previous study at 80.68%: Z = 4.32974 + 3.85477 * F1 + 3.83008 * F2. An app was created to easily adjust the DV in the daily procedure.

Conclusions:

The novel formula, combined with an app using objective, real-time parameters for predicting appropriate DVs, was proposed for PD patients to optimize maximal ultrafiltration volumes and reduce subjective abdominal discomfort. DV is easy to calculate using the app, which makes it possible for physicians or patients to make frequent adjustments.

ClinicalTrial:

Not available


 Citation

Please cite as:

Wang HY, Kan WC, Chien CC, Chien TW

An App Predicting Peritoneal Dialysis Appropriate Dwell Volume for Patients in Daily Practice

JMIR Preprints. 04/06/2019:14937

DOI: 10.2196/preprints.14937

URL: https://preprints.jmir.org/preprint/14937


Request queued. Please wait while the file is being generated. It may take some time.

© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.