BACKGROUND Extracellular volume overload is a common problem in peritoneal dialysis (PD) patients and is associated with excessive mortality. We determine the effectiveness of treating PD patients with extracellular volume overload by a structured nurse-led intervention program. METHODS The hydration status of PD patients was screened by bioimpedance spectroscopy (BIS). Fluid overload was defined as overhydration volume ≥ 2 L. Patients were classified into Symptomatic and Asymptomatic Groups and were managed by a structured nurse-led intervention protocol that focused on education and motivation. Hypertonic cycles were given for short term symptom relief for the Symptomatic group. Patients were followed for 12 weeks for the change in volume status, blood pressure, knowledge and adherence as determined by standard questionnaires. RESULTS We recruited 103 patients (53 Symptomatic, 50 Asymptomatic Group. There was a significant reduction in overhydration volume 4 weeks after intervention, which was sustained by week 12; the overall reduction in overhydration volume was 0.96 ± 1.43 L at 4 weeks, and 1.06 ± 1.70 L at 12 weeks (p < 0.001 for both). The improvement was significant for both Symptomatic and Asymptomatic Groups. There was a concomitant reduction in systolic blood pressure in the Asymptomatic (146.9 ± 20.7 to 136.9 ± 19.5 mmHg, p = 0.037) but not Symptomatic group. The scores of knowledge, adherence to dietary control and advices on daily habit at week 4 were all significantly increased, and the improvement was sustained at week 12. CONCLUSIONS The structured nurse-led intervention protocol has a lasting benefit on the volume status of PD patients with extracellular volume overload. BIS screening allows prompt identification of volume overload in asymptomatic patients, and facilitates a focused effort on this high risk group.

中文翻译：

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通过结构化的护士领导的干预方案来管理慢性腹膜透析患者的体液超负荷的疗效。

背景技术细胞外体积超负荷是腹膜透析（PD）患者中的普遍问题，并且与过度的死亡率有关。我们通过结构化的由护士领导的干预计划来确定治疗细胞外容量超负荷的PD患者的有效性。方法采用生物阻抗光谱法（BIS）筛查PD患者的水合作用状况。体液超负荷定义为脱水量≥2L。将患者分为有症状组和无症状组，并通过以护士为主导的结构化干预方案进行管理，该方案着重于教育和动机。对症状组给予高渗循环以减轻短期症状。通过标准问卷调查，对患者进行了12周的随访，以观察他们的体液状态，血压，知识和依从性变化。结论结构化的护士指导的干预方案对患有细胞外容量超负荷的PD患者的容量状态具有持久的益处。BIS筛查可以迅速识别无症状患者的容量超负荷，并有助于针对这一高风险人群的重点研究。