Effectiveness Of Volume Management Intervention On Volume Overload And Cardiac Function In Patients With Continuous Ambulatory Peritoneal Dialysis

Objective: The objective of the study was to evaluate the effect of volume managem-en（tVM）intervention on volume overload and cardiac function in patients with continuousambulatory peritoneal dialysis(CAPD).Methods: Patients who met our inclusion criteria were randomized into interventiongroup and control group. Intervention group received VM intervention followe up for6m-onths with scheduled clinics and (or) telephone visits, focusing on necessity of VM, impro-ving ability of VM, education of daily volume overload monitoring and actions to deal wit-h sudden volume overload, while control group received usual care, Scores of Volume Kn-owledge Questionnaire, Chronic Disease Self-efficacy Scale and Volume Management Be-havior Scale, the integral level (degree of edema, body weight, urinary volume, ultrafiltrat-ion and blood pressure), the cell and tissue level (ICM, ECM, TBW and ECW∕h),the ca-rdiac function (BNP) and volume overload-related re-hospitalization were compared at en-rollment and at6month.Results: At months6, the scores of volume knowledge level, self-efficacy level, saltand volume restriction capacity in intervention group were increased significantly compa-red with control group (p＜0.05, respectively). With-in comparison showed that in inter-vention group, all of the three scales improved significantly compared with enrollment(p＜0.05, respectively). In control group, the scores of the above three scales were improve-d.However, no significant differece compared with enrollment(p＞0.05, respectively).The integral level, such as degree of edema, body weight and systolic blood pressurein intervention group, were significantly lower compared with control group at months6(p＜0.05, respectively). With-in comparison showed that all of the above indices weredecreased than enrollment in intervention group(p＜0.05, respectively), whereas in contr-ol group the above indices were not changed.At months6, ICW、ECW、TBW and ECW∕h in intervention group were all signif- icantly lower compared with control group (p＜0.05, respectively). With-in analysis sh-owed that above indices were all lower than enrollment in intervention group, but therewere no signifcant difference. In control group, all of four indices were higher thanenrollment, however, there were no signifcant difference between them.The cardiac function level in intervention group was significantly lower than in contr-ol group at months6(χ2=5.945, p=0.019).Patients in intervention group yielded significantly less volume overload-related re-h-ospitalization than control group during the follow-up (0.177±0.459vs.0.469±0.671, t=2.053, p=0.045).Conclusion: The VM intervention could increase patients’ VM ability from the know-ledge, attitude and practice of VM, and improve patients’ volume overloaded status, cardi-ac function and volume overload-related re-hospitalization. VM strategy is an easy, cheap-er and effective way to improve volume overload and delay heart failure progression.