Division of Nephrology, Department of Internal Medicine, School of Medicine, Jeju National University, Jeju National University Hospital, 15, Aran 13-gil, Jeju City, Jeju, 63241, Republic of Korea.
Int Urol Nephrol. 2018 May;50(5):947-953. doi: 10.1007/s11255-018-1827-8. Epub 2018 Feb 23.
Segmental bioimpedance analysis (BIA) can identify fluid volume changes in the arms of patients on hemodialysis (HD) after vascular access surgery. We investigated whether the difference in fluid volumes between the arms of the patients using segmental BIA is associated with vascular access outcome.
Body composition measurements were taken for 127 patients on HD with segmental, multi-frequency BIA equipment (InBody 1.0, Biospace Co. Ltd, Seoul, Korea). The difference in fluid volume between the arms of the patients was calculated from the fluid volume of the arm with the vascular access minus that of the other. The primary outcome was the loss of vascular access patency within 3 months of BIA measurement.
The median absolute and relative inter-arm fluid volume differences were 150 ml [interquartile range (IQR) 90-250 ml] and 9.6% (IQR 4.9-14.4%), respectively. Within 3 months of BIA measurement, 38 patients (30.0%) experienced vascular access failure. When the patients were divided into three groups based on the tertiles of relative inter-arm fluid volume differences (lowest tertile: < 6.8%; middle tertile: 6.8-12.7%; highest tertile: > 12.7%), greater difference in relative inter-arm fluid volume differences was associated with higher vascular access failure rates (14 vs. 28 vs. 48%, p value for trend across tertiles = 0.003).
We conclude that segmental BIA may be used as a tool that can predict vascular access failure in patients on HD by calculating the relative difference in fluid volume between the arms of the patients with and without vascular access.
节段生物阻抗分析（BIA）可用于检测血管通路手术后血液透析（HD）患者手臂的液体容量变化。我们研究了患者手臂间的液体容量差异是否与血管通路结果相关。
使用节段性多频 BIA 设备（InBody 1.0，Biospace Co. Ltd，首尔，韩国）对 127 名 HD 患者进行身体成分测量。从有血管通路的手臂的液体容量中减去另一只手臂的液体容量，计算出患者手臂间的液体容量差异。主要结局是 BIA 测量后 3 个月内血管通路失功。
手臂间的液体容量绝对差值和相对差值中位数分别为 150ml[四分位距（IQR）90-250ml]和 9.6%（IQR 4.9-14.4%）。在 BIA 测量后 3 个月内，38 名患者（30.0%）出现血管通路失功。根据相对手臂间液体容量差值的三分位数（最低三分位：<6.8%；中间三分位：6.8-12.7%；最高三分位：>12.7%）将患者分为三组，相对手臂间液体容量差值越大，血管通路失功率越高（14% vs. 28% vs. 48%，三分位组间趋势检验 p 值=0.003）。
我们得出结论，节段 BIA 可用于通过计算有和无血管通路的患者手臂间的液体容量相对差值，作为预测 HD 患者血管通路失功的工具。
