Brain natriuretic peptide and impedance cardiography to assess volume status in peritoneal dialysis patients.
Brain natriuretic peptide and impedance cardiography to assess volume status in peritoneal dialysis patients.
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脑钠尿肽和阻抗心动图评估腹膜透析患者的容量状态。
DOI：
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发表时间：
2007
期刊：
影响因子：
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通讯作者：
F. Finkelstein
中科院分区：
文献类型：
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作者：
C. Granja;P. Tailor;N. Gorban‐Brennan;J. Francis;Amenuve M. Bekui;F. Finkelstein
评估终末期肾病患者的容量状况长期以来一直是一个问题。估计干重的客观工具是必要的。本研究旨在确定是否可以通过生物阻抗法测量脑利钠肽(BNP)和胸液含量(TFC)来更好地评估容量状况。我们前瞻性地调查了51名医学上稳定的腹膜透析(PD)患者，他们在我们的腹膜透析设施进行常规访问。没有排除标准。临床容量状态由主治医师评估为低血容量、正常血容量或高血容量。一旦临床评估完成，测量血浆BNP浓度。用生物阻抗心动图测定仰卧位时的TFC。在51例患者中，19例(37.3%)经临床评估为高血容量，30例(58.8%)为正常血容量，3例(5.9%)为低血容量。根据收缩压和/或舒张压和/或80毫米汞的定义，57%的人患有高血压。由于样本量较小，低血容量组被排除在统计分析之外。Logistic回归分析显示，临床容量评估与BNP(p=0.76)或TFC(p=0.39)之间没有显著相关性。我们的数据证明了BNP和胸阻抗在帮助临床评估一组慢性PD患者的容量状态方面的局限性。
Assessment of volume status in patients with end-stage renal disease has long been a problem. Objective tools for estimating dry weight are necessary. The present study was designed to determine if better assessment of volume status could be achieved by measuring brain natriuretic peptide (BNP) and thoracic fluid content (TFC) by bioimpedance. We prospectively surveyed 51 medically stable peritoneal dialysis (PD) patients during their routine visits to our PD facility. There were no exclusion criteria. Clinical volume status was assessed by the attending nephrologist as hypovolemic, euvolemic, or hypervolemic. Once the clinical assessment was complete, plasma BNP concentration was measured. The TFC was determined by bioimpedance cardiography measured in the supine position. Of 51 patients, 19 (37.3%) were considered hypervolemic, 30 (58.8%) euvolemic, and 3 (5.9%) hypovolemic by clinical assessment. As defined by systolic blood pressure > or = 130 mmHg or diastolic pressure > or = 80 mmHg (or both), 57% were hypertensive. The hypovolemic group was excluded from the statistical analysis because of the small sample size. Logistic regression analysis did not show a significant correlation between clinical assessment of volume and BNP (p = 0.76) or TFC (p = 0.39). Our data demonstrate the limitations of BNP and thoracic impedance in helping with the clinical evaluation of volume status in a cohort of chronic PD patients.