Chinese Journal of Blood Purification

Chinese Journal of Blood Purification ›› 2020, Vol. 19 ›› Issue (03): 174-178.doi: 10.3969/j.issn.1671-4091.2020.03.008

Previous Articles     Next Articles

A multicenter study of the relationship between fluid status assessed by bioimpedance analysis and blood pressure in maintenance hemodialysis patients#br#

  

  1. 1 Blood Purification Center, Department of Nephrology, Peking University International Hospital, Beijing 102206, China; 2 Department of Nephrology, Peking University People’s Hospital, Beijing 100044, China; 3 Central for Kidney Disease, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, China;
    4 Department of Nephrology, Beijing Bo’ai Hospital, China Rehabilitation Research Center, School of Rehabilitation Medicine, Capital Medical University, Beijing 100068, China;  5 Department of Nephrology, Beijing Geriatric Hospital, Beijing 100095, China;  6 Department of Nephrology, Aviation General Hospital, Beijing 100012, China;  7 Department of Nephrology, Beijing Changping Hospital, Beijing 102200, China
  • Received:2020-01-06 Revised:2020-01-15 Online:2020-03-12 Published:2020-03-12
  • Contact: Mei /Wang E-mail:wangmei1949@163.com

PDF

838

Abstract:

【Abstract】Objective Bioimpedance analysis (BIA) was used to evaluate volume load and the blood pressure (BP) at home was measured at the same time to study the relationship between fluid status and BP in maintenance hemodialysis (MHD) patients. Methods A total of 113 MHD patients in the 7 blood purification centers in Beijing were enrolled in this study. BIA was used to measure the overhydration (OH) status and to calculate the weekly timEaveraged overhydration (wTAOH). The patients were then assigned into 4 groups: the dehydration group (group 1, wTAOH less than - 0.25L), the normohydration group (group 2, ≤- 0.25L
wTAOH ≤1.25L), the overhydration group (group 3, <1.25L wTAOH ≤2.8L), and severe overhydration group (group 4, wTAOH >2.8L). The home systolic blood pressure (HSBP) and the related parameters were compared among the 4 groups. The patients were divided into 3 categories based on the HSBP in a week: class 1 (HSBP <135mmHg), class 2 (≤135mmHg HSBP <160mmHg) and class 3 (HSBP≥160mmHg). Pearson correlation analysis was used to investigate the relationship between wTAOH and HSBP. Results BIA found that the rates of MHD patients with overhydration (group 3) and severe overhydration (group 4) were 28.3% and 18.6%, respectively; the rates of the patients with normohydration (group 2) and dehydration (group 1) were 40.7% and 12%, respectively. The MHD patients in class 1(HSBP <135mmHg), class 2 (≤ 135mmHg HSBP <160mmHg) and class 3 (HSBP >160mmHg) were 30.0%, 41.6% and 28.4%, respectively. Pearson correlation revealed that wTAOH was positively correlated with HSBP (r=0.200, P=0.033). The HSBP was higher in group 4 than in groups 2 and 3 (156.0±16.9 vs. 143.0±17.5mmHg, t=2.773, P=0.007 for group 4 vs. group 2; 156.0±16.9 vs. 145.7±18.5mmHg, t=2.051, P=0.043 for group 4 vs. group 3) but had no statistical significance between groups 4 and 1. Conclusion Overhydration is prevalent in MHD patients. BP is positively correlated with overhydration. However, BP cannot accurately reflect volume load status, especially the normohydration and dehydration status, in MHD patients.

Key words: Bioimpedance analysis, Home blood pressure, Overhydration, Maintenance hemodialysis; Multicenter

CLC Number: