ABSTRACT
Objective·To explore the association of fat content with left ventricular hypertrophy (LVH) in peritoneal dialysis (PD) patients.Methods · Eligible PD patients in Renji Hospital,Shanghai Jiao Tong University School of Medicine from November 2016 to June 2017 were recruited.Demographic data of patients were collected and biochemical indicators were measured.Fat content was measured by bioelectrical impedance analysis,and LVH was accessed using echocardiography.The prevalence of LVH in PD patients was compared between groups with different fat contents.Logistic regression was used to analyze the associated risk factors of LVH.Results · A total of 163 PD patients with a mean age of 55.85±13.20 years and a median PD duration of 46.0 (20.0,73.0) months were enrolled.Of them,98 patients (60.1％) were male,34 patients (20.9％) had diabetes mellitus,19 patients (11.7％) combined with cardiovascular disease and 122 patients (74.8％) were hypertensive.There were 51 patients (31.3％) with LVH,including 31 patients (37.8％) in high fat tissue index (FTI) group (n=82) and 20 patients (24.7％) in low FTI group (n=81).Logistic regression analysis indicated that FTI (OR=1.133,95％ CI 1.003-1.280,P=0.044),overhydration (OR=1.651,95％ CI 1.257-2.169,P=0.000) and hemoglobin (OR=0.972,95％ CI 0.948-0.997,P=0.028) were independently associated with LVH in PD patients.Conclusion · LVH is common in PD patients,especially in high fat content patients.Higher fat content,higher overhydration and lower levels of hemoglobin are risk factors for LVH in PD patients.
ABSTRACT
Objective: To investigate the role of common clinical indicators in volume assessments of peritoneal dialysis (PD) patients. Methods: Eligible PD patients in Renji Hospital, Shanghai Jiao Tong University School of Medicine from Nov. 2016 to Nov. 2017 were enrolled. Demographic data of patients were collected and clinical parameters were measured. Hydration status index overhydration (OH) was measured by bioimpedance spectroscopy, and the association between clinical indicators and OH was analyzed. Results: A total of 200 PD patients aged 56.3±13.8 years with median PD duration of 46.6 months were enrolled in the study. Among them, 117 (58.5%) patients were males and 42 (21.0%) patients were diabetic. 141 (70.5%) patients in the present study were overhydrated (OH>1.1 L). Compared to those with normal hydration, the overhydrated patients had higher blood pressure, more obvious edema and higher brain natriuretic peptide (BNP) level (P<0.05). In the overhydrated patients, 51 (36.2%) patients had normal blood pressure, 67 (47.5%) patients had no edema and 46 (32.6%) patients had BNP less than 100 pg/mL. In the normal hydrated patients, 20 (33.9%) patients had high blood pressure, 8 (13.6%) patients had edema and 1 (1.7%) patient had BNP higher than 400 pg/mL. Systolic pressure and BNP level were both correlated with OH positively (systolic pressure r=0.361, P=0.001; BNP r=0.615, P=0.000). The patients who had more obvious edema also had higher OH (P=0.000). Conclusion: Blood pressure, edema and BNP are closely associated with the hydration status, but only one of these clinical indicators can not accurately reflect the hydration status in all PD patients. Combination of different indicators may be useful in evaluation of hydration status in PD patients.