应用多频生物电阻抗法调节血液透析患者干体重对血压的影响

目的 观察在多频生物电阻抗法指导下调节干体重(DBW)对血液透析患者血压及透析相关并发症的影响.方法 应用多频生物电阻抗分析仪测量细胞外液(ECW).根据同性别正常对照组的ECW值确定正常参考范围.对ECW增高(提示容量过负荷)者,逐步降低DBW,观察ECW和血压的变化.对ECW降低(提示容量不足)者,逐步升高DBW,...

Effect of adjusting dry weight by bio-impedance spectrum analysis on blood pressure control in hemodialysis patients

Objective To evaluate fluid distribution in patients on maintenance hemodialysis by whole-body bioimpedance spectroscopy and to evaluate the effect of adjusting dry body weight(DBW)on blood pressure control and complications in hemodialysis patients. Methods One hundred and nineteen stable hemodialysis patients were enrolled. Post-dialysis extracellular water(ECW)were measured by whole-body multi-frequency bioimpedance spectroscopy (Bodystat,UK) and standardized using body weight(ECW%). Eighty-two cases of sex,age and body weight matched normal individuals were selected as controls. DBW was adjusted according to the ECW%,and the effect of adjusting DBW on blood pressure control and complications was evaluated. Results Systolic blood pressure was significantly reduced after decreasing DBW in the group with high ECW% from (165±15)mmHg to (142±10)mmHg in males,P < 0.01; from (160±7)mmHg to (138±6)mmHg in females,P < 0.01)],whereas dialysis-related complications didn’t increase. DBW was increased in five symptomatic normotensive patients with low ECW%. The ECW% and blood pressure remained unchanged,while intradialytic symptoms improved. Conclusions Bio-impedance spectrum analysis is helpful for estimation of volume status and blood pressure control in hemodialysis patients.