Merhametsiz O, Oguz E G, Yayar O, Bektan B, Canbakan B, Ayli D
Department of Nephrology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
Department of Internal Medicine, Ankara Numune Training and Research Hospital, Ankara, Turkey.
Hippokratia. 2015 Oct-Dec;19(4):324-31.
Hypervolemia is a major risk factor for hypertension leading to cardiovascular diseases and also a frequent problem in maintenance hemodialysis (MHD) patients. Fluid overload (FO) can be determined by bioimpedance spectroscopy (BIS) which is a new, practical, and non-invasive method. We tried to determine FO by BIS in MHD patients and find out the relationship between FO and clinical features.
We studied 100 MHD patients aged between 20 and 85 years and undergoing hemodialysis three times weekly for minimum one year. By using BIS, we estimated FO and extracellular water (ECW). The patients who exhibited a FO/ECW ratio >15% were considered as FO.
Twenty-nine (29.0%) patients had a FO/ECW ratio >15%. In the overhydrated group, the mean pre-hemodialysis systolic blood pressure was 153.3 ± 20.0 mmHg and the mean diastolic blood pressure was 89.1 ± 8.5 mmHg. These were significantly higher than in the non-overhydrated group (113.5 ± 14.5 and 71.0 ± 8.8, p <0.001). FO was significantly correlated with systolic and diastolic blood pressures (r =0.63, p <0.001 and r =0.59, p <0.001). The patients were divided into two groups, i.e. those with cardiothoracic index (CTI) of >0.5 and those with CTI of ≤0.5. The median FO/ECW ratio was 0.11 L in the former group and 0.08 L in the latter group with a significant difference (p =0.006).
Hypervolemia is associated with high blood pressure and left ventricular hypertrophy that should be treated effectively to prevent cardiovascular diseases in MHD patients. BIS is useful to assess hydration status in MHD patients. Hippokratia 2015; 19 (4): 324-331.
血容量过多是导致心血管疾病的高血压的主要危险因素，也是维持性血液透析（MHD）患者常见的问题。液体超负荷（FO）可通过生物电阻抗光谱法（BIS）来确定，这是一种新的、实用的非侵入性方法。我们试图通过BIS测定MHD患者的FO，并找出FO与临床特征之间的关系。
我们研究了100例年龄在20至85岁之间、每周进行3次血液透析且至少持续1年的MHD患者。通过使用BIS，我们估算了FO和细胞外液（ECW）。FO/ECW比值>15%的患者被视为存在FO。
29例（29.0%）患者的FO/ECW比值>15%。在液体过多组中，血液透析前收缩压均值为153.3±20.0 mmHg，舒张压均值为89.1±8.5 mmHg。这些值显著高于非液体过多组（113.5±14.5和71.0±8.8，p<0.001）。FO与收缩压和舒张压显著相关（r=0.63，p<0.001；r=0.59，p<0.001）。患者被分为两组，即心胸指数（CTI）>0.5的患者和CTI≤0.5的患者。前一组的FO/ECW比值中位数为0.11 L，后一组为0.08 L，差异有统计学意义（p=0.006）。
血容量过多与高血压和左心室肥厚相关，应有效治疗以预防MHD患者的心血管疾病。BIS有助于评估MHD患者的水合状态。《希波克拉底》2015年；19（4）：324 - 331。
