标题:
Bioimpedance-guided fluid management can improve the outcome of peritoneal dialysis patient: a prospective random control trial
讲者:
田娜
单位:
宁夏医科大学总医院
播放:
2010
论文摘要:
Aim To investigate the influence of fluid management guided by BIA for PD patients.
Method A prospective randomized controlled trial was designed. Prevalent PD patients with volume overload were recruited, while those with combined dialysis modality (PD+ HD) and severe heart failure or severe malnutrition were excluded. The patients were randomly assigned 1:1 to either BIA-guided group or doctor empirical method-guided group (control) and were followed up for one year.
Results A total of 240 eligible patients were enrolled. No statistical difference at baseline characteristics was found between the two groups. (1) At the end of follow-up,11 (4.58%) cases of death were observed. Censoring due to receiving kidney transplant occurred in 11 (4.58%) individuals, permanently switching to HD in 21 (8.75%) patients. (2) Alleviation of fluid overload: extracellular water (ECW) / total body water (TBW) over time was significantly decreased in both groups, however, the decline rate of ECW/TBW was much faster in BIA group than in the control (p = 0.04). (3) The one-year mortality was no statistically different between two groups (p = 0.12). (4) Technique survival was tendency to be higher in the BIA group (p = 0.06). (5) There were no statistical difference in the 31 cardiovascular events (p = 0.30). (6) The hypertensive urgencies were tendency to be more frequently occurred in the control group than the BIA group (p = 0.07). (7) Hospitalization: ① Altogether there were less hospitalization episodes in BIA group than control group (p = 0.01); ② The incidence of non-catheter associated infection episode was higher in control group than BIA group (p = 0.007). (8) Cardiac dilation and remodeling was much better improved in BIA group, in left atrial diameter, left ventricular diastolic diameter, interventricular septal thickness and left ventricular mass index (p < 0.001).
Conclusion Our study provided evidence that volume management guided by BIA is an efficient way than the conventional method in terms of alleviating fluid overload, decreasing hospitalization rate and improving cardial dilation and remodeling.