Novel equations for estimating intraperitoneal pressure among peritoneal dialysis patients

Xinqiu Li, Tiantian Ma, Jiayu Hao, Di Song, Hongyan Wang, Tianjiao Liu, Yaling Zhang, Nanzha Abi, Xiao Xu, Manze Zhang, Weiqi Sun, Xin Li, Jie Dong, Xinqiu Li, Tiantian Ma, Jiayu Hao, Di Song, Hongyan Wang, Tianjiao Liu, Yaling Zhang, Nanzha Abi, Xiao Xu, Manze Zhang, Weiqi Sun, Xin Li, Jie Dong

Abstract

Background: Increased intraperitoneal pressure (IPP) is associated with abdominal wall complications and technical failure in peritoneal dialysis (PD). Since the standard measurement of IPP is limited due to its cumbersome procedures, we aimed to develop and validate equations for estimating IPP.

Methods: We performed a cross-sectional study with a total of 200 prevalent PD patients who were divided into development and validation datasets after random sampling matched by body mass index. The IPPs were measured using the Durand method, with whole-body and abdominal anthropometry indices collected. Equations with 2.0-L and 1.5-L fill volumes were generated by stepwise linear regression modelling. The bias, accuracy and precision of the estimated IPP (eIPP) with 2-L and 1.5-L fill volumes were compared with actual IPPs by the Durand method. The eIPP for the 2-L fill volume was also compared with other existing equations.

Results: Two new equations incorporating waist circumference and height from the decubitus plane to mid-axillary line were generated. The eIPPs exhibited small biases in relation to the Durand method , with median differences of -0.24 cmH2O and -0.10 cmH2O for 2 L and 1.5 L, respectively. The precisions evaluated by the standard deviation of the absolute value of the differences were 2.59 cmH2O and 2.50 cmH2O, respectively. The accuracies evaluated by the value of the percentage of estimates that differed by >20% for the eIPP were 26% for 2.0 L and 27% for 1.5 L. Better bias, precision and accuracy were observed for the eIPP equation compared with other existing equations for the 2.0-L fill volume.

Conclusions: We provided two new equations developed from abdominal anthropometry indices to accurately estimate the IPP in the PD population.

Keywords: Durand method; anthropometry indices; intraperitoneal pressure; novel equation; peritoneal dialysis; technical failure.

Conflict of interest statement

The authors declare that they have no conflicts of interest. The results presented in this article have not been published previously in whole or part.

© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.

Figures

Graphical Abstract
Graphical Abstract
Figure 1:
Figure 1:
Flow chart of the study.
Figure 2:
Figure 2:
Bias and precision of the new equation and other existing equations with a 2-L fill volume (n = 100). Statistical test: box plot. The box represents the median and IQR of data and the whiskers represent the maximum and minimum values. *Denotes extremes in the box plot that were >3 box lengths away from the upper quartile or the lower quartile.
Figure 3:
Figure 3:
Difference between IPP measured by the Durand method (aIPP) and that measured by (A) the new equation (eIPP), (B) the Castellanos equation, (C) the Scanziani equation and (D) the De Jesus Ventura equation with a 2-L fill volume in the validation dataset of 100 patients. Statistical test: Bland–Altman analysis.

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Source: PubMed

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