血液透析中早期透析低血压期间细胞间生物阻抗测量变化的影响。

The effect of changes in intra-compartmental bioimpedance measurements with early intra-dialytic hypotension during haemodialysis.

机构信息

Division of Nephrology, Department of Medicine, National University Health System, Singapore, Singapore.

University College London, Department of Renal Medicine, Royal Free Hospital, London, UK.

出版信息

Int J Artif Organs. 2024 Nov;47(11):802-809. doi: 10.1177/03913988241269444. Epub 2024 Aug 21.

DOI:10.1177/03913988241269444

PMID:39166424

Abstract

INTRODUCTION

Intra-dialytic hypotension (IDH) remains the commonest problem associated with routine haemodialysis treatments. Fluid shifts from intracellular(ICW) and extracellular(ECW) compartments to refill plasma volume during haemodialysis with ultrafiltration.

METHODS

We studied the effect of relative changes in ICW and ECW indifferent body segments using multifrequency segmental bioimpedance during haemodialysis and IDH episodes.

RESULTS

Of 42 haemodialysis patients,16 patients (38.1%) developed IDH within the first hour of dialysis. Patients with and without early IDH were well-matched for demographics and starting bioimpedance measurements. However, after 60 min, the relative change in in ECW/ICW ratio between the non-fistula arm and leg was significantly different for the early IDH group median -1.07 (-3.33 to 0.8) versus 0.61 (-0.78 to 1.8), < 0.05, whereas there no differences in ultrafiltration rate, relative blood volume monitoring or on-line clearance.

CONCLUSION

Monitoring serial changes in fluid status in different body compartments with bioimpedance may potentially prevent IDH in the future.

摘要

简介

透析中低血压（IDH）仍然是与常规血液透析治疗相关的最常见问题。在血液透析过程中，通过超滤，液体从细胞内（ICW）和细胞外（ECW）腔室转移到血浆体积中。

方法

我们使用多频节段生物阻抗研究了 IDH 期间和透析过程中不同身体节段 ICW 和 ECW 相对变化的影响。

结果

在 42 名血液透析患者中，16 名（38.1%）在透析的第一个小时内发生 IDH。有和没有早期 IDH 的患者在人口统计学和起始生物阻抗测量方面匹配良好。然而，60 分钟后，早期 IDH 组非瘘侧肢体的 ECW/ICW 比值的相对变化明显不同，中位数为-1.07（-3.33 至 0.8）与 0.61（-0.78 至 1.8），<0.05，而超滤率、相对血容量监测或在线清除率无差异。