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在腹膜透析患者中,使用生物电阻抗分析进行身体成分测量会受到透析液的影响。

Body composition measurements using bioimpedance analysis in peritoneal dialysis patients are affected by the presence of dialysate.

作者信息

Kang Seok Hui, Cho Kyu Hyang, Park Jong Won, Yoon Kyung Woo, Do Jun Young

机构信息

Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea.

出版信息

Nephrology (Carlton). 2014 Nov;19(11):727-31. doi: 10.1111/nep.12322.

Abstract

The presence of peritoneal dialysate when performing bioimpedance analysis may affect body composition measurements. The aim of this study was to evaluate the impact of dialysate on body composition measurements in Asians. Forty-one patients undergoing maintenance peritoneal dialysis in our hospital peritoneal dialysis unit were included in this study. Dialysate was drained from the abdomen prior to measurement, and bioimpedance analysis was performed using multi-frequency bioimpedance analysis, with each subject in a standing position (D-). Dialysate was then administered and the measurement was repeated (D+). The presence of peritoneal dialysate led to an increase in intracellular water (ICW), extracellular water (ECW), and total body water (D-: 20.33 ± 3.72 L for ICW and 13.53 ± 2.54 L for ECW; D+: 20.96 ± 3.78 L for ICW and 14.10 ± 2.59 L for ECW; P < 0.001 for both variables). Total and trunk oedema indices were higher in the presence of peritoneal dialysate. In addition, the presence of peritoneal dialysate led to an overestimation of mineral content and free fat mass (FFM) for the total body; but led to an underestimation of body fat (D-: 45.80 ± 8.26 kg for FFM and 19.30 ± 6.27 kg for body fat; D+: 47.51 ± 8.38 kg for FFM and 17.59 ± 6.47 kg for body fat; P < 0.001 for both variables). Our results demonstrate that the presence of peritoneal dialysate leads to an overestimation of FFM and an underestimation of fat mass. An empty abdomen is recommended when evaluating body composition using bioimpedance analysis.

摘要

进行生物电阻抗分析时腹膜透析液的存在可能会影响身体成分测量。本研究的目的是评估透析液对亚洲人身体成分测量的影响。本研究纳入了我院腹膜透析单元41例接受维持性腹膜透析的患者。测量前将透析液从腹腔引出,采用多频生物电阻抗分析对每位站立位的受试者进行生物电阻抗分析(D-)。然后注入透析液并重复测量(D+)。腹膜透析液的存在导致细胞内液(ICW)、细胞外液(ECW)和总体液增加(D-:ICW为20.33±3.72L,ECW为13.53±2.54L;D+:ICW为20.96±3.78L,ECW为14.10±2.59L;两个变量P均<0.001)。存在腹膜透析液时,全身和躯干水肿指数更高。此外,腹膜透析液的存在导致对全身矿物质含量和游离脂肪量(FFM)的高估;但导致对体脂的低估(D-:FFM为45.80±8.26kg,体脂为19.30±6.27kg;D+:FFM为47.51±8.38kg,体脂为17.59±6.47kg;两个变量P均<0.001)。我们的结果表明,腹膜透析液的存在导致对FFM的高估和对脂肪量的低估。建议在使用生物电阻抗分析评估身体成分时空腹。

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