Volume Indicators and Left Ventricular Mass during Aggressive Volume Management in Patients on Thrice-Weekly Hemodialysis
Volume Indicators and Left Ventricular Mass during Aggressive Volume Management in Patients on Thrice-Weekly Hemodialysis
复制标题
每周三次血液透析患者积极容量管理期间的容量指标和左心室质量
作者：
A. Goldfarb;Madhukar Chelamcharla;B. Bray;J. Leypoldt;I. Lavasani;Natalia Nelson;Tooran Lavasani;B. Baird;A. Cheung
目的：我们检查了各种容量指标之间的关系，即多频生物电阻抗分析（BIA），透析前血清N-末端脑钠肽原（NT[-]pro[-]BNP）水平，下腔静脉直径和左心室质量指数（LVMI）在基线和每周三次血液透析的严格容量管理。方法：对22例每周3次慢性血液透析患者进行52周的随访。基线时队列中100%存在左心室肥大。结果如下：除了6个月时细胞外体积与体重比和膨胀指数之间的相关性（r = 0.476; p = 0.039）外，体积指标之间无显著相关性。血压和容量指标之间没有相关性。基线（而非随访）可耐受性指数与LVMI相关（r = 0.506; p = 0.038）。在“滞后时间”分析中，基线或6个月时的体积指标与随后时间点的LVMI之间没有相关性。LVMI从基线时的243.6 ± 83.3 g/m2降至6个月时的210.6 ± 62.9 g/m2（p = 0.104），并进一步降至12个月时的203.2 ± 49.0 g/m2（p = 0.035）。结论：（1）血液透析患者普遍存在左心室肥大;（2）BIA、下腔静脉超声和血清NT-pro-BNP水平对液体容量产生不一致的结果;（3）LVMI的消退可能发生在严格的液体管理中，即使是每周三次透析。
Objective: We examined the relationship between various volume indicators, i.e. multifrequency bioelectric impedance analysis (BIA), predialysis serum N-terminus-pro-brain natriuretic peptide (NT[-]pro[-]BNP) levels, and inferior vena cava diameter, and left ventricular mass index (LVMI) at baseline and with rigorous volume management on thrice-weekly hemodialysis. Methods: Twenty-two patients on chronic thrice-weekly hemodialysis were followed for 52 weeks. Left ventricular hypertrophy was present in 100% of the cohort at baseline. Results: There were no significant correlations among volume indicators except for a correlation between extracellular-volume-to-body-mass ratio and collapsibility index (r = 0.476; p = 0.039) at 6 months. There were no correlations between blood pressure and volume indicators. Baseline (but not follow-up) collapsibility index correlated with LVMI (r = 0.506; p = 0.038). In ‘lag-time’ analyses, there were no correlations between volume indicators at baseline or 6 months and LVMI at subsequent time points. LVMI decreased from 243.6 ± 83.3 g/m2 at baseline to 210.6 ± 62.9 g/m2 at 6 months (p = 0.104) and further to 203.2 ± 49.0 g/m2 at 12 months (p = 0.035). Conclusions: (1) Left ventricular hypertrophy was prevalent in hemodialysis patients; (2) BIA, inferior vena cava ultrasound and serum NT-pro-BNP levels yield discordant results for fluid volumes; (3) regression of LVMI could occur with rigorous fluid management, even with thrice-weekly dialysis.
机械和生理调节剂以及身体成分的生物电阻抗谱决定因素。
DOI：
10.1093/ajcn/64.3.413s
发表时间：
1996
期刊：
The American journal of clinical nutrition.
影响因子：
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作者：
Chumlea,WC;Guo,SS;Cockram,DB;Siervogel,RM
通讯作者：
Siervogel,RM