Unal Aydin, Kavuncuoglu Feridun, Duran Mustafa, Oguz Fatih, Kocyigit Ismail, Sipahioglu Murat Hayri, Tokgoz Bulent, Oymak Oktay
a Department of Nephrology and.
b Department of Cardiology, Erciyes University Medical School , Kayseri , Turkey.
Ren Fail. 2015 Jul;37(6):935-40. doi: 10.3109/0886022X.2015.1040337. Epub 2015 May 6.
The aim of this study is to investigate whether there is a relationship between inflammation and volume status in patients underwent peritoneal dialysis (PD).
This cross-sectional study included 159 PD patients. The median duration of PD was 17 (range, 1-151) months. All patients were examined using bioelectrical impedance analysis to estimate the ratio of extracellular water to total body water (ECW/TBW), which was used to assess their volume status. The patients were categorized as having one of the following three volume statuses: hypervolemic (above +2 SD from the mean, which was obtained from healthy controls), normovolemic (between +2 SD and -2 SD), or hypovolemic (below -2 SD from the mean). Five patients with hypovolemia were excluded from the study. Fifty-six patients were hypervolemic whereas 98 patients were euvolemic. High-sensitive C-reactive protein (hs-CRP) levels were measured to evaluate inflammation in all patients.
hs-CRP value levels were significantly higher in hypervolemic patients compared with euvolemic patients [7.1 (3.1-44.0) mg/L vs. 4.3 (3.1-39.6), p: 0.015, respectively]. Left ventricular hypertrophy was more frequent in hypervolemic patients compared with euvolemic patients (53.6% vs. 30.6%, p: 0.004, respectively). ECW/TBW ratio positively correlated with hs-CRP (r: 0.166, p: 0.039). Gender, hs-CRP, and residual Kt/V urea were found to be independent risk factors for hypervolemia in multivariate analysis.
Inflammation is associated with hypervolemia in PD patients. Residual renal functions play an important role to maintain euvolemia in PD patients.
本研究旨在调查接受腹膜透析（PD）的患者炎症与容量状态之间是否存在关联。
这项横断面研究纳入了159例PD患者。PD的中位持续时间为17（范围1 - 151）个月。所有患者均采用生物电阻抗分析进行检查，以估计细胞外液与总体液的比率（ECW/TBW），该比率用于评估他们的容量状态。患者被分类为具有以下三种容量状态之一：高血容量（高于健康对照的均值 +2标准差）、正常血容量（在 +2标准差和 -2标准差之间）或低血容量（低于均值 -2标准差）。5例低血容量患者被排除在研究之外。56例患者为高血容量，而98例患者为正常血容量。测量所有患者的高敏C反应蛋白（hs-CRP）水平以评估炎症。
高血容量患者的hs-CRP值水平显著高于正常血容量患者[分别为7.1（3.1 - 44.0）mg/L与4.3（3.1 - 39.6）mg/L，p：0.015]。与正常血容量患者相比，高血容量患者左心室肥厚更常见（分别为53.6%与30.6%，p：0.004）。ECW/TBW比率与hs-CRP呈正相关（r：0.166，p：0.039）。在多变量分析中，性别、hs-CRP和残余Kt/V尿素被发现是高血容量的独立危险因素。
炎症与PD患者的高血容量相关。残余肾功能在维持PD患者的正常血容量中起重要作用。
