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通过生物电阻抗分析和NT-脑钠肽前体测定糖尿病透析前患者的容量超负荷情况

DETERMINATION OF VOLUME OVERLOAD BY BIOELECTRICAL IMPEDANCE ANALYSIS AND NT-PROBNP IN DIABETIC PRE-DIALYSIS PATIENTS.

作者信息

Yildirim Y, Kara A V, Kilinç F, Aydin F, Aydin E, Yilmaz Z, Kadiroglu A K, Yilmaz M E

机构信息

Dicle University, Faculty of Medicine, Dept. of Nephrology, Diyarbakir, Turkey.

Dicle University, Faculty of Medicine, Dept. of Endocrinology, Diyarbakir, Turkey.

出版信息

Acta Endocrinol (Buchar). 2016 Jan-Mar;12(1):19-25. doi: 10.4183/aeb.2016.19.

Abstract

INTRODUCTION

Diabetic chronic kidney disease has more fatal clinical progresses and this situation can be related to volume overload, which is seen more commonly in diabetic chronic kidney disease patients than in non-diabetic chronic kidney disease patients. Therefore, we examined the effect of diabetes mellitus on volume overload in newly diagnosed stage 5 chronic kidney disease patients whose volume overloads were not showing signs of improvement from renal replacement therapy.

METHOD

One hundred and five patients (46 diabetic, 59 non-diabetic) with end-stage chronic kidney disease, who had glomerular filtration rate (GFR) under 15 mL/min for at least three months were enrolled in this prospective study. We determined the body volume overload and configuration using a bioimpedance device. NT-proBNP levels were recorded.

RESULTS

There was a statistically significant difference between diabetic and non-diabetic groups according to overhydration (OH, p=0.003), extracellular water (ECW, p=0.045), intracellular water (ICW, p<0.001) and OH/ECW (p=0.003). In addition, there was a statistically significant difference between groups in terms of N-terminal Pro-brain Natriuretic Peptide (NT-proBNP levels, p=0.008).

DISCUSSION

We compared diabetic and non-diabetic end-stage chronic kidney disease patients who were not in renal replacement therapy yet. We found more volume overload and extracellular fluid volume in the diabetic group.

摘要

引言

糖尿病慢性肾脏病具有更致命的临床进展,这种情况可能与容量超负荷有关,糖尿病慢性肾脏病患者中容量超负荷的情况比非糖尿病慢性肾脏病患者更为常见。因此,我们研究了糖尿病对新诊断的5期慢性肾脏病患者容量超负荷的影响,这些患者的容量超负荷未因肾脏替代治疗而改善。

方法

105例终末期慢性肾脏病患者(46例糖尿病患者,59例非糖尿病患者)纳入本前瞻性研究,这些患者的肾小球滤过率(GFR)低于15 mL/分钟至少三个月。我们使用生物阻抗装置测定身体容量超负荷和结构。记录NT-proBNP水平。

结果

根据水过多(OH,p=0.003)、细胞外液(ECW,p=0.045)、细胞内液(ICW,p<0.001)和OH/ECW(p=0.003),糖尿病组和非糖尿病组之间存在统计学显著差异。此外,两组之间在N端脑钠肽前体(NT-proBNP水平,p=0.008)方面也存在统计学显著差异。

讨论

我们比较了尚未接受肾脏替代治疗的糖尿病和非糖尿病终末期慢性肾脏病患者。我们发现糖尿病组的容量超负荷和细胞外液量更多。

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