Influencing Factors and Prognostic Value of Intraperitoneal Pressure (IPP) in Peritoneal Dialysis (PD) patients: A systematic review and meta-analysis

E-Poster

https://storage.unitedwebnetwork.com/files/1099/8aa8685f1eb15cedbe1eaaf5a0624026.pdf

Abstract Title

First Name *

Ka Chun

Last Name *

Leung

Co-author 1

Stephen Mahony stephen.mahony@nhs.net Imperial College Healthcare NHS Trust West London Renal and Transplantation Center LONDON

Co-author 2

Richard Corbett richard.corbett@imperial.ac.uk Imperial College Healthcare NHS Trust West London Renal and Transplantation Center LONDON

Co-author 3

Edwina Brown e.a.brown@imperial.ac.uk Imperial College Healthcare NHS Trust West London Renal and Transplantation Center LONDON

Co-author 4

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Introduction

With the growing popularity of PD, challenges due to its related non-infective mechanical complication have also raised. IPP was proven to offer diagnostic and prognostic benefits in pediatric PD patients in acute setting. However, its value in chronic monitoring of adult PD patients remains ambiguous. Current literature presents a diverse and occasionally conflicting perspective on the factors affecting IPP, equations that estimate IPP and its prognostic value in PD patients. This systematic review aims to discern the variables significantly influencing IPP measurements and its prognostic values in predicting non-infective mechanical risks in PD patients.

Methods

Databases including MEDLINE, EMBASE, and Cochrane were searched from January 1990 to July 2023. Randomised and non-randomized trials reporting IPP measured by Durand method, factors affecting IPP and related non-infective mechanical complications were incorporated. Primary outcomes revolved around variables significantly associated with IPP in linear regression modelling. Data synthesis integrated meta-analysis using DerSimonian and Laird random effects model with narrative synthesis. Statistical analyses were executed using Python 3.11, with a significance threshold of p-value < 0.05.

Results

From 1828 potential studies, 12 were integrated for systematic review, with 10 being included for meta-analysis. Body Mass Index (BMI) and Body Surface Area (BSA) emerged as positively correlated with IPP (BMI: r = 0.49, 95% CI 0.35 – 0.61, I² = 67.39%, p = 0.003; BSA: r = 0.2, 95% CI 0.08 – 0.31, I² = 14.10%, p = 0.324)(Figure 1). Conversely, age, Intraperitoneal Volume (IPV), and the Charlson Comorbidity Index demonstrated varied results (Figure 1). Subgroup analysis accentuated higher IPP in patients with elevated BMI and BSA. However, there appeared to be limited correlation between IPP and non-infective mechanical complications.

Conclusions

There is a strong association between IPP and specific anthropometric variables, particularly BMI and BSA. The role for routine IPP measurement in PD remains unclear, given the absence of evidence of association between IPP and clinical outcomes. However, in an era of high-quality personalised prescribing, further studies robustly examining the association of IPP with clinical outcomes are warranted.

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