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使用生物电阻抗光谱法评估影响血液透析患者达到干体重时间的因素。

Evaluation of factors affecting time to achieve dry weight among hemodialysis patients using bioimpedance spectroscopy.

作者信息

Khan Amjad, Khan Amer Hayat, Adnan Azreen Syazril, Sulaiman Syed Azhar Syed, Ahmad Nafees, Gan Siew Hua

机构信息

Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Penang, Malaysia.

Chronic Kidney Disease Resource Centre, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerain, 16150, Kelantan, Malaysia.

出版信息

Ir J Med Sci. 2019 Feb;188(1):311-319. doi: 10.1007/s11845-018-1813-2. Epub 2018 Apr 22.

Abstract

BACKGROUND

Achieving and maintaining dry weight appears to be an effective strategy for controlling and maintaining normotension among hypertensive patients on hemodialysis (HD).

OBJECTIVE

The present study aimed to determine the time at which the majority of patients achieve postdialysis dry weight using bioimpedance spectroscopy (BIS).

METHODS

A total of 220 HD patients were prospectively assessed for fluid overload using the Fresenius body composition monitor (BCM). BCM readings were taken at 30 and 45 min postdialysis.

RESULTS

Among the 220 patients included in this study, 120 (54.5%) achieved a euvolemic state at 30 min, and 25 (11.4%) achieved it at 45 min according to the BCM. In the multivariate analysis, vascular access other than arteriovenous fistula (AVF) (OR = 0.286, p value = 0.049) and cardiovascular disease (OR = 0.384, p value = 0.026) had a statistically significant negative association and receiving HD at Hospital Universiti Sains Malaysia (HUSM) (OR = 2.705, p value = 0.008) had a statistically significant positive association with achieving a euvolemic state at 30 min.

CONCLUSION

This suggests that assessing the hydration status at 45 min postdialysis in all patients or in those with identified risk factors for not achieving a euvolemic state at 30 min will provide a relatively accurate assessment for most patients.

摘要

背景

实现并维持干体重似乎是控制和维持血液透析(HD)高血压患者血压正常的有效策略。

目的

本研究旨在确定大多数患者使用生物电阻抗光谱法(BIS)达到透析后干体重的时间。

方法

使用费森尤斯人体成分监测仪(BCM)对总共220例HD患者进行前瞻性液体超负荷评估。在透析后30分钟和45分钟进行BCM读数。

结果

根据BCM,在本研究纳入的220例患者中,120例(54.5%)在30分钟时达到了血容量正常状态,25例(11.4%)在45分钟时达到该状态。在多变量分析中,除动静脉内瘘(AVF)外的血管通路(OR = 0.286,p值 = 0.049)和心血管疾病(OR = 0.384,p值 = 0.026)与在30分钟时达到血容量正常状态具有统计学显著负相关,而在马来西亚理科大学医院(HUSM)接受HD治疗(OR = 2.705,p值 = 0.008)与在30分钟时达到血容量正常状态具有统计学显著正相关。

结论

这表明,对所有患者或对那些在30分钟时未达到血容量正常状态且具有已确定危险因素的患者,在透析后45分钟评估其水合状态将为大多数患者提供相对准确的评估。

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