Department of Nephrology, The Second Affiliated Hospital of Chongqing Medical University, Lingjiang Road, Yuzhong District, Chongqing, 400010, China.
Int Urol Nephrol. 2020 May;52(5):953-958. doi: 10.1007/s11255-020-02456-4. Epub 2020 Apr 16.
To explore the correlation between body composition measurement by bioelectrical impedance analysis (BIA) and intradialytic hypotension (IDH).
The clinical data of 127 patients with end-stage renal disease (ESRD) who underwent regular dialysis in the Blood Purification Center of the Second Affiliated Hospital of Chongqing Medical University were retrospectively analyzed. According to the occurrence of IDH, the patients were divided into IDH group and intradialytic normotension group. The difference in body composition measured by BIA and its relationship with IDH were compared between the two groups.
Compared with intradialytic normotension group, the intracellular water (ICW) ratio (P = 0.009), extracellular water (ECW) ratio (P = 0.029), total body water (TBW) ratio (P = 0.012), protein ratio (P = 0.010), soft lean mass (SLM) ratio (P = 0.011), fat-free mass (FFM) ratio (P = 0.012) and skeletal muscle mass (SMM) ratio (P = 0.009) in IDH group were significantly decreased. However, the fat mass (FM) ratio (P = 0.016), percentage body fat (PBF) ratio (P = 0.001), extracellular water/total body water (ECW/TBW) ratio (P = 0.036), extracellular water/total body water in trunk (ECW/TBWT) ratio (P = 0.045) and visceral fat area (VFA) (P = 0.003) in IDH group were significantly increased when compared with intradialytic normotension group. In addition, there was a positive correlation between systolic blood pressure (SBP) during IDH and ECW ratio, ECW/TBW ratio, and ECW/TBWTR ratio before dialysis.
The body composition of dialysis patients is closely related to the occurrence of IDH. Strengthening the body composition management of dialysis patients outside the hospital may reduce the occurrence of IDH and improve the long-term prognosis of dialysis patients.
探讨生物电阻抗分析（BIA）测量的人体成分与透析中低血压（IDH）的相关性。
回顾性分析重庆医科大学第二附属医院血液净化中心 127 例行规律透析的终末期肾病（ESRD）患者的临床资料。根据 IDH 的发生情况，将患者分为 IDH 组和透析中血压正常组。比较两组 BIA 测量的人体成分差异及其与 IDH 的关系。
与透析中血压正常组相比，IDH 组细胞内液（ICW）比值（P = 0.009）、细胞外液（ECW）比值（P = 0.029）、总水量（TBW）比值（P = 0.012）、蛋白比值（P = 0.010）、瘦体软组织（SLM）比值（P = 0.011）、去脂体重（FFM）比值（P = 0.012）和骨骼肌质量（SMM）比值（P = 0.009）均显著降低。然而，IDH 组的脂肪量（FM）比值（P = 0.016）、体脂百分比（PBF）比值（P = 0.001）、细胞外液/总水量（ECW/TBW）比值（P = 0.036）、细胞外液/躯干总水量（ECW/TBWT）比值（P = 0.045）和内脏脂肪面积（VFA）（P = 0.003）均显著升高。此外，透析中 IDH 时的收缩压（SBP）与透析前的 ECW 比值、ECW/TBW 比值和 ECW/TBWTR 比值呈正相关。
透析患者的人体成分与 IDH 的发生密切相关。加强透析患者院外的人体成分管理，可能减少 IDH 的发生，改善透析患者的长期预后。
