Huan-Sheng Chen, Yeong-Chang Chang, Ming-Hsing Hsieh, Fan-Lieh Tseng, Chu-Cheng Lin, Tsai-Kun Wu, Hung-Ping Chen, Sze-Hung Hung, Hsien-Chang Chiu, Chia-Chen Lee, Chun-Cheng Hou, Chun-Ting Cheng, Hung-Hsiang Liou, Chun-Ju Lin, Paik-Seong Lim
An Hsin QingShui Clinic, Taichung, Taiwan.
Sheng An Clinic, Yunlin, Taiwan.
Int Urol Nephrol. 2016 Nov;48(11):1897-1909. doi: 10.1007/s11255-016-1415-8. Epub 2016 Sep 12.
Fluid management with body composition monitor based on bioimpedance spectroscopy (BCM-BIS) has been found to be beneficial for dialysis patients. We conducted a study to provide an algorithm for the determination of post-dialysis target weight (PDTW) and to evaluate whether this approach could improve clinical outcomes compared to patients who had PDTW decided clinically.
Two hundred and ninety-eight dialysis patients participated in this 1-year randomized controlled trial. The outcomes were all-cause hospitalization rate, AFO or CV-related events, hypertension and intra-dialysis morbidities.
80 % of post-dialysis weight reached the target set with current algorithm. All-cause hospitalization rate was not different. Incidence of acute fluid overload (AFO) or CV-related events was lower in study group. Longitudinal data showed decreased incidence of hypertension, intra-dialysis morbidities and intra-dialysis hypotension.
Assessment of PDTW by BCM-BIS with an explicit algorithm decreased AFO or CV-related events, hypertension and intra-dialysis morbidities. Further studies were required to demonstrate possible benefits of hospitalization rate.
已发现基于生物电阻抗光谱法的人体成分监测仪（BCM - BIS）进行液体管理对透析患者有益。我们开展了一项研究，以提供一种确定透析后目标体重（PDTW）的算法，并评估与临床确定PDTW的患者相比，这种方法是否能改善临床结局。
298名透析患者参与了这项为期1年的随机对照试验。结局指标为全因住院率、急性液体过载（AFO）或心血管相关事件、高血压及透析期间并发症。
80%的透析后体重达到了当前算法设定的目标。全因住院率无差异。研究组急性液体过载（AFO）或心血管相关事件的发生率较低。纵向数据显示高血压、透析期间并发症及透析期间低血压的发生率降低。
采用明确算法的BCM - BIS评估PDTW可降低AFO或心血管相关事件、高血压及透析期间并发症的发生率。需要进一步研究以证明其对住院率可能产生的益处。
