生物电阻抗法评估干体质量对维持性血液透析患者残余肾功能的影响

    The effect of evaluation of dry weight using bioimpedance method on residual renal function in maintenance hemodialysis patients

    • 摘要: 目的 应用生物电阻抗方法评估维持性血液透析(MHD)患者干体质量,观察精确评估干体质量对MHD患者残余肾功能的保护。方法 40例MHD患者入选,24 h尿量 ≥ 400 mL,随机分成试验组和对照组,试验组用生物电阻抗分析仪确定干体质量,对照组临床评估干体质量。随访4个月,对比基线及随访结束的24 h尿量、体质量、平均动脉压、透析超滤量、透析间期体质量增长百分率,BNP、心脏彩超EF值、左室质量指数等以及透析相关急性并发症。结果 试验组的平均动脉压低于对照组(92.0±9.3)vs(96.5±8.5),P<0.05;试验组BNP低于对照组(280.3±410.5) vs(471.7±786.0),P<0.05;试验组24 h尿量高于对照组(649.2±289.3) vs(562.5±224.8),P<0.05。结论 应用生物电阻抗技术精确评估干体质量,可延缓因过度超滤导致的尿量减少,对残余肾功能具有保护作用,同时能够改善平均动脉压。增加检测频率可能进一步降低透析相关并发症。

       

      Abstract: Objective To evaluate the dry weight of maintenance hemodialysis (MHD) patients using bioimpedance method and to observe the protective effect of the accurate evaluation of dry weight on residual renal function in patients with MHD. Methods Forty patients with MHD were enrolled, whose 24-hour urinary volumes were ≥ 400 mL. They were randomly divided into the trial group and control group. The dry weight in the trial group was determined with a bioimpedance analyzer, and the dry weight in the control group was evaluated clinically. After 4 months of follow-up, the 24-hour urine volume, body weight, mean arterial pressure, dialysis ultrafiltration volume, percentage of weight gain during inter-dialysis, BNP, EF value of colorful ECG, left ventricular mass index, and dialysis-related acute complications were compared between theirbaselines and values at the last follow-up. Results Thetrial group had lower mean arterial pressure(92.0±9.3) vs(96.5±8.5), P<0.05, lower BNP(280.3±410.5) vs(471.7±786.0), P<0.05, and higher 24-hour urine volume(649.2±289.3) vs(562.5±224.8),P<0.05 than the control group. Conclusions The application of bioimpedance technology in accurately assessing dry weight can delay the urine reduction caused by excessive ultrafiltration,has a protective effect on residual renal function, and can improve mean arterial pressure at the same time. Increasing the frequency of detection may further reduce dialysis-related complications.

       

    /

    返回文章
    返回