Evaluation of Fluid Overload in Peritoneal Dialysis Patients Based on the Deviation of Actual Body Weight from Dry Weight

Corresponding author: xiongfei, xiongf23@sina.com

DOI: 10.12201/bmr.202602.00066

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  Abstract: : Objective: To evaluate the application value of the deviation of actual body weight from dry weight(calculated as the percentage difference between the patients actual weight and the BCM-assessed dry weight) in assessing volume status in peritoneal dialysis patients. Methods: A study of maintenance peritoneal dialysis patients was conducted. Patient basic characteristics and biochemical data were collected. Patients were grouped based on the deviation of their actual body weight from dry weight. The validity of using the Over-hydration (OH) value as a diagnostic criterion was verified. The study investigated the relationships between OH and laboratory parameters and dialysis adequacy, and analyzed the impact of volume load on the occurrence of cardiovascular/cerebrovascular events and patient survival. Results: A total of 118 maintenance peritoneal dialysis patients were included. Using the OH value as the diagnostic standard, the distribution of the deviation of actual weight from dry weight showed a gradient increase across different volume status groups. ROC curve analysis identified the optimal cut-off value for discriminating volume overload as 2.015%(AUC=0.982) and for severe volume overload as 4.165%(AUC=0.979). The deviation was negatively correlated with serum albumin, total Kt/V, residual renal function, and residual urine volume, positively correlated with CCI score, CRP, and blood pressure(P<0.05). Male, low serum albumin, diabetes, high systolic blood pressure, and low post-void residual urine volume are independent risk factors for increased deviation (P<0.05).The survival rate in experimental group B was significantly lower than that in the control group and experimental group A (P<0.05),and the risk of cardiovascular and cerebrovascular events was significantly higher than in the control group and experimental group A(P<0.05). Conclusion: Deviation of actual weight from dry weight is a reliable indicator for assessing volume load in peritoneal dialysis patients. Based on its high specificity, high positive predictive value, and feasibility, cutoff values of 2% and 5% can be used to distinguish volume overload and severe volume overload, respectively. This indicator is associated with parameters reflecting patients nutritional status, inflammatory levels, and dialysis adequacy. Volume overload significantly increases the risk of cardiovascular and cerebrovascular events and reduces survival rates.

  Key words: Peritoneal dialysis; volume load; dry body weight

  Submit time: 14 February 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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