Division of Nephrology, Department of Medicine, National Yang-Ming University Hospital, Yilan, Taiwan.
Blood Purif. 2012;34(1):40-7. doi: 10.1159/000338964. Epub 2012 Aug 24.
BACKGROUND/AIMS: Fluid overload is an important factor causing cardiovascular complications in dialysis patients. We compared fluid status, blood pressure (BP) and heart function between peritoneal dialysis (PD) patients and hemodialysis (HD) patients.
We recruited 94 PD and 75 HD patients in our hospital. Fluid status was assessed by bioimpedance spectroscopy. Home BP was recorded. Use of antihypertensives was retrieved by chart review. In each group, 39 patients received echocardiographic examinations.
PD patients' fluid status was similar to that of predialysis HD patients. PD patients had lower systolic BP. E/E' and left ventricular mass index (LVMI) showed no significant intergroup difference. In multiple linear regression analyses, overhydration (OH)/extracellular water ratio >0.15 was associated with higher systolic BP, E/E' and LVMI.
While PD was associated with higher OH but non-inferior BP control and heart function, OH was indeed related to poor BP control, diastolic dysfunction and left ventricular hypertrophy.
背景/目的:液体超负荷是导致透析患者心血管并发症的一个重要因素。我们比较了腹膜透析(PD)和血液透析(HD)患者的液体状态、血压(BP)和心脏功能。
我们招募了我院 94 名 PD 患者和 75 名 HD 患者。通过生物电阻抗谱评估液体状态。记录家庭血压。通过病历回顾了解抗高血压药物的使用情况。在每组中,有 39 名患者接受了超声心动图检查。
PD 患者的液体状态与透析前 HD 患者相似。PD 患者的收缩压较低。E/E'和左心室质量指数(LVMI)在两组间无显著差异。在多元线性回归分析中,超量液(OH)/细胞外液比值>0.15 与较高的收缩压、E/E'和 LVMI 相关。
尽管 PD 与较高的 OH 相关,但与血压控制和心脏功能无显著差异,OH 确实与血压控制不佳、舒张功能障碍和左心室肥厚有关。