Division of Nephrology, Peking University Third Hospital, Beijing 100191, PR China.
Blood Purif. 2011;31(4):289-95. doi: 10.1159/000322615. Epub 2011 Jan 14.
Overhydration (OH) is a well-recognized problem in peritoneal dialysis (PD) patients and is an independent risk factor of mortality in this patient population. Achieving normohydration remains an important issue in dialysis therapy. The present study tries to compare clinical signs and find the optimal range for PD patients in China.
A new bioimpedance spectroscopy device [body composition monitor (BCM)], which allows quantitative determination of how much the hydration status deviates from normal ranges (ΔHS), was selected. Blood pressure and ΔHS were analyzed in 92 PD patients from 1 dialysis center and compared with a matched healthy population (n = 45). Statistical analysis was performed using SPSS software, version 16.0 (SPSS Inc., Chicago, Ill., USA).
We took different OH values as cutoff thresholds; predictive accuracy was evaluated with sensitivity and specificity, and a receiver-operating characteristics curve and Youden's index were adopted.
Our data suggest that 2.0 liters is a reasonable cutoff value for ΔHS. This represents an important step towards a more objective choice of strategies for the optimal treatment of hypertension and fluid overload.
水过多（OH）是腹膜透析（PD）患者中一个公认的问题，也是该患者人群死亡的一个独立危险因素。实现正常水化仍然是透析治疗中的一个重要问题。本研究试图比较临床体征，并为中国 PD 患者找到最佳范围。
选择了一种新的生物阻抗谱设备[身体成分监测仪（BCM）]，该设备允许定量确定水合状态偏离正常范围的程度（ΔHS）。对来自 1 个透析中心的 92 名 PD 患者的血压和 ΔHS 进行了分析，并与匹配的健康人群（n=45）进行了比较。使用 SPSS 软件，版本 16.0（SPSS Inc.，芝加哥，伊利诺伊州，美国）进行统计分析。
我们以不同的 OH 值作为截断阈值；采用灵敏度和特异性评估预测准确性，并采用受试者工作特征曲线和 Youden 指数。
我们的数据表明，2.0 升是 ΔHS 的一个合理截断值。这是朝着更客观地选择治疗高血压和液体超负荷的最佳策略迈出的重要一步。
