Santa Casa de Misericórdia de Porto Alegre, Departamento de Nefrologia e Transplante de Rim e Pâncreas, Porto Alegre, RS, Brazil.
Universidade Federal de Ciências da Saúde de Porto Alegre, Programa de Pós-Graduação em Patologia, Porto Alegre, RS, Brazil.
J Bras Nefrol. 2023 Jul-Sep;45(3):277-286. doi: 10.1590/2175-8239-JBN-2022-0037en.
Bioimpedance analysis (BIA) has been demonstrated to add accuracy to nutritional and volume status assessments in dialysis (HD) patients.
to describe a sample of dialysis patients from a single center on their demographics and BIA of volume distribution and nutritional status, and mortality during 12-month follow-up.
prospective observational cohort study to evaluate vintage HD patients with single-frequency BIA.
we evaluated 82 patients, 29% over 65 years old. Elderly patients had higher ECW/TBW (0.51 vs. 0.44, p < 0.0001), and narrower phase angle (PhA) (4.9 vs. 6.4º, p < 0.0001). Fifteen patients (18.2%) died during follow-up, eight (53%) were elderly. Death was associated with age (62.6 vs. 50.2 years, p = 0.012), post-HD PhA (4.8 vs. 6.2º, p = 0.0001), and post-HD ECW/TBW (0.50 vs. 0.45, p = 0.015). The ROC curve analysis to predict mortality found ECW/TBW ≥ 0.47 and PhA ≤ 5.5º to have the best sensitivity and specificity. One-year patient survival was lower with post-HD ECW/TBW ≥ 0.47 (69.5% vs. 90.6%, p = 0.019), age ≥ 65 years (64.2%, vs. 86.2%, p = 0.029), and PhA ≤ 5.5º (68.2 vs. 91.0%, p = 0.002). Cox regression analysis demonstrated that PhA [HR 5.04 (95%CI 1.60-15.86), p = 0.006] remained associated with death after adjusting for age and ECW/TBW.
BIA is useful in assessing volume distribution and nutrition in HD patients, and combined with clinical judgement, may help determine dry weight, especially in elderly patients. Narrower PhA and higher ECW/TBW after HD were associated with poorer one-year survival.
生物阻抗分析（BIA）已被证明可提高透析（HD）患者营养和容量状态评估的准确性。
描述单一中心的透析患者的样本，描述其容量分布和营养状况的 BIA 以及 12 个月随访期间的死亡率。
前瞻性观察队列研究，评估使用单频 BIA 的老式 HD 患者。
我们评估了 82 名患者，其中 29%年龄超过 65 岁。老年患者的细胞外液/总体重（ECW/TBW）更高（0.51 比 0.44，p <0.0001），且相位角（PhA）更窄（4.9 比 6.4°，p <0.0001）。在随访期间，有 15 名患者（18.2%）死亡，其中 8 名（53%）为老年人。死亡与年龄（62.6 比 50.2 岁，p = 0.012）、HD 后 PhA（4.8 比 6.2°，p = 0.0001）和 HD 后 ECW/TBW（0.50 比 0.45，p = 0.015）相关。预测死亡率的 ROC 曲线分析发现，ECW/TBW ≥ 0.47 和 PhA ≤ 5.5°具有最佳的敏感性和特异性。HD 后 ECW/TBW ≥ 0.47（69.5%比 90.6%，p = 0.019）、年龄≥65 岁（64.2%比 86.2%，p = 0.029）和 PhA ≤ 5.5°（68.2%比 91.0%，p = 0.002）患者的 1 年生存率较低。Cox 回归分析表明，在调整年龄和 ECW/TBW 后，PhA [HR 5.04（95%CI 1.60-15.86），p = 0.006]与死亡相关。
BIA 可用于评估 HD 患者的容量分布和营养状况，与临床判断相结合，可能有助于确定干体重，尤其是老年患者。HD 后 PhA 变窄和 ECW/TBW 升高与较差的 1 年生存率相关。
