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田娜:Bioimpedance-guided fluid management can improve the outcome of peritoneal dialysis patient: a prospective random control trial PPT讲座视频 The 8th Asia Pacific Chapter Meeting of International Society for Peritoneal Dialysis (APCM-ISPD 2017)
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.

肾内科

宁夏医科大学总医院

宁夏医科大学总医院肾脏内科科主任,主任医师,博导,副教授 

中山大学肾脏病学博士 

国际肾脏病学会访问学者(香港威尔士亲王医院)  

中华医学会肾脏病分会青年委员 

中国医师协会肾脏内科医师分会青年委员 

中国医促会肾脏病防治分会委员兼工作秘书 

中华CSPEN肾病营养协作组委员 

宁夏医学会肾脏病分会委员兼秘书 

承担国家自然科学基金、宁夏自然科学基金、省级重点研发项目

及国家级横向联合课题18项;发表科研论文46 篇,其中SCI收录15篇

?《Nephrology》,《Peritoneal Dialysis International》, 《Medicine Advances》,《中华肾脏病杂志》,《中国血液净化杂志》审稿人


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