ABSTRACT
Objective · To assess volume status in maintenance hemodialysis (MHD) patients.Methods · Body composition analysis was performed on 128 MHD patients from Renji Hospital,Shanghai Jiao Tong University School of Medicine.The volume status was assessed based on body composition data and predialysis systolic blood pressure (preBPsys),edema grade,brain natriuretic peptide (BNP).Patients were divided into hyperhydrated group (percentage of hydration status,HS％＞ 15％) or normohydrated group (HS％ ≤ 15％).Body composition data were compared,including lean tissue index (LTI) and fat tissue index (FTI).The blood pressure,edema grade,serum calcium,serum phosphate,intact parathyroid hormone (iPTH),hemoglobin,albumin,pre-albumin,hypersensitive C-reactive protein (hs-CRP),serum sodium,and urea clearance Kt/V were compared between two groups.Results · Sixtynine patients were normohydrated and preBPsys reached target;10 patients were overhydrated with higher preBPsys;18 patients had overhydration but preBPsys was in target range.Compared to normohydraed group,patients in hyperhydmted group had more obvious edema,higher BNP level,significantly lower LTI,serum albumin and pre-albumin levels,while serum sodium was significantly higher (P＜0.05).Conclusion· Volume status of hemodialysis patients can be objectively and accurately assessed by body composition analysis using bioimpedance technique with blood pressure,edema grade and biochemical parameters.Hyperhydrated patients may have higher serum sodium level,lower serum albumin,lower hemoglobin,and less lean tissue mass concomitantly.Sodium intake control,nutrition status improvement,and anemia correction may be useful to reduce hyperhydration.
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.