生物电阻抗分析法指导透析超滤对残余肾功能的保护作用

目的 观察生物电阻抗分析法指导新进入血液透析患者对残余肾功能（residual renal function，RRF）的保护作用。方法 选取2015年1月~2016年6月新进入血液透析的终末期肾病患者，随机分为试验组及对照组，随访3个月。试验组应用生物电阻抗分析法指导透析超滤，对照组依据有无水肿、透析过程中有无低血压症状及透析间期体重增加量来确定透析超滤量。比较两组前后的RRF、24 h尿量、透析不良事件发生率。结果 随访3月后，试验组24 h尿量（932.58±230.16）ml与对照组24 h尿量（584.45±137.76）ml比较差异有统计学意义（t=7.226，P<0.001）。试验组RRF（4.55±0.90）ml/min与对照组RRF（3.08±0.68）ml/min比较差异有统计学意义（t=7.300，P<0.001）。试验组RRF下降值（3.14±2.05）ml/min与对照组RRF下降值（4.40±2.09）ml/min比较差异有统计学意义（t=-2.384，P=0.020）。试验组24 h尿量下降值（452.58±456.96）ml与对照组24 h尿量下降值（877.45±452.45）ml比较差异有统计学意义（t=-3.679，P=0.001）。试验组发生不良事件次数共2次，对照组发生不良事件次数共8次，两组比较差异无意义（t=2.081，P=0.084）。结论 应用生物电阻抗分析法指导新入血液透析患者超滤，有助于延缓RRF的下降。

The protective effect of bioimpedance spectroscopy guided ultrafiltration on residual renal function in hemodialysis patients

Objective To observe the protective effect of bioimpedance spectroscopy guided ultrahltration on residual renal function in new hemodialysis patients.Methods Patients with end-stage renal disease recruited from January 2015 to June 2016,were randomly divided into experimental group and control group.And all the patients were followed up for 3 months.The ultrafiltration was guided by the bioimpedance spectroscopy analysis in the experimental group,while the ultrafiltration was based on the edema,blood pressure,symptoms of low blood pressure and the increase of weight during the hemodialysis interphase in the control group.The difference of residual renal function,24 hours urine volume and the incidence rate of adverse events between the two groups were collected.Results Compared with the control group,the urine volume(932.58 ± 230.16 ml vs 584.45 ± 137.76 ml,t =7.226,P ＜ 0.001) and residual renal function (RRF) (4.55 ± 0.90 ml/min vs 3.08 ±0.68 ml/min,t =7.300,P ＜0.001)in the experimental group were higher.The drop of RRF(3.14 ±2.05 ml/min vs 4.40 ±2.09 ml/min,t =-2.384,P =0.020) and urinary volume (452.58 ±456.96 ml vs 877.45 ± 452.45 ml,t =-3.679,P =0.001) were lower in the experimental group.While there was no significant difference in the incidence of adverse events between the two groups (t =2.081,P =0.084).Conclusions It is helpful for slowing down the decline of residual renal function by using the bioimpedance spectroscopy guided ultrafiltration.