Reference values for multifrequency bioimpedance analysis in dialysis patients
Reference values for multifrequency bioimpedance analysis in dialysis patients
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DOI：
10.1159/000078761
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发表时间：
2004-01-01
影响因子：
3
通讯作者：
Kooman, JP
中科院分区：
文献类型：
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作者：
van de Kerkhof, J;Hermans, M;Kooman, JP
背景：多频生物阻抗（MF-BIA）在评估透析患者体液状态中的作用尚未完全阐明。特别是，细胞外水（ECW）的参考值的预测值尚未得到解决。本研究的目的是使用严格的临床标准和超声心动图作为参考技术，验证MF-BIA诊断透析患者高血容量的临界值。研究方法：将90例患者[ 42例接受血液透析; 48例接受腹膜透析]分为以下组：临床血容量正常（平均24或48小时收缩压低于133 mm Hg，未使用抗高血压药物; n = 12），“高血容量”（平均收缩压高于133 mm Hg，使用2种或2种以上降压药; n = 34）或未确定（n = 44）。临床血容量正常患者的标准化ECW的第80百分位数用作参考值。20名年龄匹配的健康对照者被纳入进行比较。结果如下：在“正常血容量”受试者中，ECW：体重（BW）和ECW：身高的第80次测量值分别为0.245 L/kg（男性）和10.96 L/m2，0.232 L/kg（女性）和9.13 L/m2。ECW：BW和ECW：身高分别在34例“高血容量”患者中的26例（灵敏度76%）和29例（灵敏度86%）高于这些值。在未确定组中，标准化ECW低于和高于这些截止值的患者之间的左心室舒张末期直径有显著差异（49.0 +/- 5.1 vs. 52.4 +/- 5.7 mm; p < 0.05）。使用ECW：TBW比率产生低灵敏度（45%）。ECW：与健康对照组相比，“正常血容量”透析患者的身高较低（9.7 +/- 1.3 l/m vs 12.2 +/- 1.9 l/m）。结论：在我们的研究人群中，根据严格的临床标准，MF-BIA的ECW（身高标准化）能够预测高血容量，灵敏度为86%，特异性为80%。ECW的标准化程序可能会影响水化状态的分类。严格血压正常的透析患者的标准化ECW低于健康对照组。版权所有（C）2004 S. Karger AG，巴塞尔。
Background: The role of multifrequency bioimpedance (MF-BIA) in the assessment of fluid status in dialysis patients is still not fully elucidated. Especially, the predictive value of reference values for extracellular water (ECW) has not yet been addressed. Aim of the present study was to validate cut-off values for MF-BIA in the diagnosis of hypervolemia in dialysis patients, using strict clinical criteria and echocardiography as reference techniques. Methods: 90 patients [ 42 on hemodialysis; 48 on peritoneal dialysis] were divided into the following groups: clinically normovolemic ( mean 24- or 48-hour systolic blood pressure below 133 mm Hg without use of antihypertensive agents; n = 12), 'hypervolemic' ( mean systolic blood pressure above 133 mm Hg with 2 or more antihypertensive agents; n = 34) or undetermined ( n = 44). The 80th percentile for normalized ECW in the clinically normovolemic patients was used as reference value. 20 healthy age-matched controls were included for comparison. Results: The 80th percentiles for ECW: body weight (BW) and ECW: height in 'normovolemic' subjects were, respectively, 0.245 liters/kg and 10.96 liters/m in males, and 0.232 liters/kg and 9.13 liters/m in females. ECW: BW and ECW: height were above these values in, respectively, 26 ( sensitivity 76%) and 29 ( sensitivity 86%) of the 34 'hypervolemic' patients. In the undetermined group, left ventricular end-diastolic diameter was significantly different between patients with normalized ECW below and above these cut-off values (49.0 +/- 5.1 vs. 52.4 +/- 5.7 mm; p < 0.05). Use of the ECW: TBW ratio resulted yielded low sensitivity (45%). ECW: height was lower in the 'normovolemic' dialysis patients compared to healthy controls (9.7 +/- 1.3 l/m versus 12.2 +/- 1.9 l/m). Conclusion: In our study population, ECW by MF-BIA, normalized for height was able to predict hypervolemia, based on strict clinical criteria, with a sensitivity of 86% and a specificity of 80%. The normalization procedure for ECW may influence the classification of hydration status. Strictly normotensive dialysis patients had lower normalized ECW than healthy control subjects. Copyright (C) 2004 S. Karger AG, Basel.