Vujicić Bozidar, Mikolasević Ivana, Racki Sanjin, Orlić Lidija, Ljutić Dragan, Bubić Ivan
University of Rijeka, University Hospital Centre Rijeka, Department of Nephrology and Dialysis, Rijeka, Croatia.
Coll Antropol. 2013 Sep;37(3):815-9.
Hypertension is a common finding in end-stage renal disease patients with the prevalence between 20 to 85%. Although the etiology of arterial hypertension (AH) in this patient group is multifactorial, sodium and volume excess leading to extracellular volume overload are one of the most important and potentially adjustable causes. Control of volume status can either normalize the blood pressure (BP) or make the AH easier to control in the great majority of dialysis patients. Heavy reliance is placed on the dialysis procedure to gradually remove fluid over a period of days to weeks until a stable dry weight is achieved. Numerous attempts have been made to utilize alternative methods to more accurately assessment of dry weight, and the newest and most interesting method is multifrequency bioelectrical impedance spectroscopy (BIS). In this prospective study we used BIS in 65 haemodialysis (HD) patients in order to detect those with volume-dependent hypertension and to further investigate the role of dry weight management in BP control. Dry weight was corrected at the beginning, and after 1, and 3 months. Final data were collected after six months. Our data showed that assessment of fluid overload using BIS provides better management of fluid status and BP control in the patients on maintenance HD, and that dry weight correction can lead to significantly better control of volume-dependent hypertension in this patient group.
高血压在终末期肾病患者中很常见，患病率在20%至85%之间。虽然该患者群体中动脉高血压（AH）的病因是多因素的，但导致细胞外液量超负荷的钠和容量过多是最重要且可能可调节的原因之一。在绝大多数透析患者中，控制容量状态可使血压（BP）正常化或使AH更易于控制。严重依赖透析程序在数天至数周的时间内逐渐清除液体，直至达到稳定的干体重。人们已经进行了许多尝试，以利用替代方法更准确地评估干体重，最新且最有趣的方法是多频生物电阻抗光谱法（BIS）。在这项前瞻性研究中，我们对65例血液透析（HD）患者使用了BIS，以检测那些患有容量依赖性高血压的患者，并进一步研究干体重管理在血压控制中的作用。在开始时、1个月后和3个月后校正干体重。六个月后收集最终数据。我们的数据表明，使用BIS评估液体超负荷可为维持性HD患者提供更好的液体状态管理和血压控制，并且干体重校正可导致该患者群体中容量依赖性高血压得到显著更好的控制。
