Woodrow Graham, Oldroyd Brian, Wright Antony, Coward W Andrew, Truscott John G, Turney John H, Brownjohn Aleck M, Smith Michael A
Renal Unit, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK.
Nephrol Dial Transplant. 2003 Feb;18(2):384-9. doi: 10.1093/ndt/18.2.384.
Several formulae exist for estimating total body water (TBW). We aimed to assess their validity in peritoneal dialysis patients by comparison with TBW estimated by deuterium oxide dilution (TBW(D)).
We compared the equations of Chertow (TBW(Cher)), Chumlea (TBW(Chum)), Hume and Weyers (TBW(HW)), Johansson (TBW(J)), Lee (TBW(L)), Watson (TBW(W)) and TBW as 58% of body weight (TBW(0.58Wt)) with TBW(D) in 31 peritoneal dialysis (PD) patients and 32 controls. Estimates were compared with TBW(D) using Bland and Altman comparison. Extracellular water (ECW) was also estimated by sodium bromide dilution.
In PD patients, mean TBW(D) was 35.04 (SD 7.84) l. Estimates were greater for TBW(Cher), TBW(Chum), TBW(HW), TBW(J) and TBW(0.58Wt). Mean TBW(L) and TBW(W) did not differ from TBW(D). Ninety-five percent limits of agreement (LOA) compared with TBW(D) (as a percentage of the mean) were similar for all of the different equations in PD patients (between +/-15.4 and +/-17.3%) except TBW(0.58Wt), which was far greater (+/-26.4%). In controls, mean TBW(D) was 37.03 (SD 6.63) l. Estimates were greater for TBW(Cher), TBW(Chum), TBW(HW), TBW(J) and TBW(0.58Wt). Mean TBW(L) and TBW(W) did not differ from TBW(D). Ninety-five percent LOA compared with TBW(D) (as a percentage of the mean) were similar for all equations in the controls, and closer than in PD patients (between +/-9.1 and +/-11.5%) except TBW(0.58Wt), which was again far greater than the other equations (+/-28.1%). TBW(HW) - TBW(D) correlated with mean TBW (r=-0.412, P<0.05 in PD and r=-0.383, P<0.05 in controls). TBW(W) - TBW(D) (r=-0.539, P<0.005) correlated with mean TBW in PD. TBW(0.58Wt) - TBW(D) correlated with body mass index (BMI) (r=0.624, P<0.0001 in PD and r=0.829, P<0.0001 in controls) and ECW/TBW (r=0.406, P<0.05 in PD and r=0.411, P<0.02 in controls).
Predictive equations were less accurate in PD than controls. TBW(0.58Wt) was most inaccurate, with systematic overestimation of TBW with increasing BMI and ECW/TBW. There were no differences in LOA with TBW(D) for the other equations within each group.
存在多种估算总体水（TBW）的公式。我们旨在通过与氧化氘稀释法估算的TBW（TBW(D)）进行比较，评估这些公式在腹膜透析患者中的有效性。
我们在31例腹膜透析（PD）患者和32例对照中，将切尔托夫公式（TBW(Cher)）、丘姆利亚公式（TBW(Chum)）、休姆和韦耶斯公式（TBW(HW)）、约翰松公式（TBW(J)）、李公式（TBW(L)）、沃森公式（TBW(W)）以及将TBW视为体重的58%（TBW(0.58Wt)）与TBW(D)进行比较。使用布兰德和奥特曼比较法将估算值与TBW(D)进行比较。细胞外液（ECW）也通过溴化钠稀释法进行估算。
在PD患者中，平均TBW(D)为35.04（标准差7.84）升。TBW(Cher)、TBW(Chum)、TBW(HW)、TBW(J)和TBW(0.58Wt)的估算值更高。平均TBW(L)和TBW(W)与TBW(D)无差异。与TBW(D)相比（以平均值的百分比表示），PD患者中所有不同公式的95%一致性界限（LOA）相似（在±15.4%至±17.3%之间），但TBW(0.58Wt)远高于此（±26.4%）。在对照中，平均TBW(D)为37.03（标准差6.63）升。TBW(Cher)、TBW(Chum)、TBW(HW)、TBW(J)和TBW(0.58Wt)的估算值更高。平均TBW(L)和TBW(W)与TBW(D)无差异。对照中所有公式与TBW(D)相比（以平均值的百分比表示）的95% LOA相似，且比PD患者更接近（在±9.1%至±11.5%之间），但TBW(0.58Wt)再次远高于其他公式（±28.1%）。TBW(HW) - TBW(D)与平均TBW相关（PD患者中r = -0.412，P < 0.05；对照中r = -0.383，P < 0.05）。TBW(W) - TBW(D)（r = -0.539，P < 0.005）与PD患者的平均TBW相关。TBW(0.58Wt) - TBW(D)与体重指数（BMI）相关（PD患者中r = 0.624，P < 0.0001；对照中r = 0.829，P < 0.0001）以及与ECW/TBW相关（PD患者中r = 0.406，P < 0.05；对照中r = 0.411，P < 0.02）。
预测公式在PD患者中不如在对照中准确。TBW(0.58Wt)最不准确，随着BMI和ECW/TBW增加，对TBW有系统性高估。每组中其他公式与TBW(D)的LOA无差异。
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