The Relationship Between Bioimpedance-Measured Volume and Nutritional Parameters and Mortality in Hemodialysis Patients
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Tarih
2017
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info:eu-repo/semantics/openAccess
Özet
AMAÇ: Hemodiyalizde hipervolemi ve malnütrisyon çoğu kez gözden kaçan risk faktörleridir. Çalışmamızda amaç, biyoempedans sektroskopi (BİS) ile gösterilen hipervolemi ve malnütrisyonun uzun dönem sağkalım üzerine etkisini araştırmaktır (Clinical Trials. gov Identifier:NCT01468363).GEREÇ ve yÖNTEMLER: Çalışmaya 431 prevalan HD hastası alınarak 32,2±14,4 ay takip edilmiştir. Hastalara BIS ölçümü yapılmış, ilaç kullanımları, bazal ve çalışma sonundaki rutin tetkikleri değerlendirilmiştir. Çalışma süresince hastane yatışları, seanslar sırasında yaşanan komplikasyonlar değerlendirilmiştir.BULGULAR: Yaş ortalaması 59,4±14,6 yıl olan toplam 431 (%53,6'sı erkek) hastadan 125'i çalışma sonunda exitus olmuştur. Diyabet oranı %47, eritropoietin %67, diüretik kullanımı %40, prediyaliz sistolik kan basıncı 133,4±25,8 diyastolik kan basıncı 79,2±12,4 mm Hg dir.Biyoempedans verilerine göre göreceli hidrasyon durumu OH/ECW değerlendirildiğinde, kümülatif sağkalım, hipervolemik olanlarda daha düşük olarak bulundu.SONUÇ: Hemodiyaliz hastalarında hipervolemi ve malnütrisyon uzun dönem mortalite göstergesidir, erken tanı ve zamanında müdahale çok önemlidir. Klinik bulgular tanıda yeterli olmayabilir laboratuvar verileri ve BİS yöntemi hipervolemi ve malnütrisyon tanısında kullanılabilir.
OBJECTIVE: Hypervolemia and malnutrition are often undiagnosed risk factors for hemodialysis (HD). Our aim was to investigate the long-term effects of hypervolemia and malnutrition evaluated by bioimpedance spectroscopy (BIS) on survival. (Clinical Trials. Gov Identifier: NCT01468363). MATERIAL and METHODS: A total of 431 Prevalent HD patients were followed for 32.2±14.4 months. the patients underwent BIS measurement, a medical history was obtained, and routine tests were analyzed at the baseline and at the end of the study. Hospitalizations and complications of HD were recorded. RESULTS: the mean age was 59.4±14.6 (10-92) years with a total of 431 (53.6% males) patients of which 125 died. the percentage of diabetics was 47%, erythropoietin use 67%, and diuretic use 40%. Predialysis systolic blood pressure (BP) was 133.4±25.8 and diastolic BP 79.2±12.4 mm Hg. the rate of diabetes, and the number of hospitalizations and blood transfusions were higher in the patients who died. Diastolic BP as a clinical hypervolemia finding, BIS hypervolemia indicator of over hydration (OH), and extracellular water (ECW) were all increased, and fat tissue index as a malnutrition finding was decreased in patients who died. There were significant rates of anemia and hypoalbuminemia in this group as well. the cumulative survival was lower in hypervolemic patients as assessed by relative hydration status OH/ECW. CONCLUSION: Hypervolemia and malnutrition are the long-term mortality indicators in hemodialysis. Early diagnosis and treatment is important. Clinical findings may not be sufficient and laboratory and BIS methods can be used for diagnosis.
OBJECTIVE: Hypervolemia and malnutrition are often undiagnosed risk factors for hemodialysis (HD). Our aim was to investigate the long-term effects of hypervolemia and malnutrition evaluated by bioimpedance spectroscopy (BIS) on survival. (Clinical Trials. Gov Identifier: NCT01468363). MATERIAL and METHODS: A total of 431 Prevalent HD patients were followed for 32.2±14.4 months. the patients underwent BIS measurement, a medical history was obtained, and routine tests were analyzed at the baseline and at the end of the study. Hospitalizations and complications of HD were recorded. RESULTS: the mean age was 59.4±14.6 (10-92) years with a total of 431 (53.6% males) patients of which 125 died. the percentage of diabetics was 47%, erythropoietin use 67%, and diuretic use 40%. Predialysis systolic blood pressure (BP) was 133.4±25.8 and diastolic BP 79.2±12.4 mm Hg. the rate of diabetes, and the number of hospitalizations and blood transfusions were higher in the patients who died. Diastolic BP as a clinical hypervolemia finding, BIS hypervolemia indicator of over hydration (OH), and extracellular water (ECW) were all increased, and fat tissue index as a malnutrition finding was decreased in patients who died. There were significant rates of anemia and hypoalbuminemia in this group as well. the cumulative survival was lower in hypervolemic patients as assessed by relative hydration status OH/ECW. CONCLUSION: Hypervolemia and malnutrition are the long-term mortality indicators in hemodialysis. Early diagnosis and treatment is important. Clinical findings may not be sufficient and laboratory and BIS methods can be used for diagnosis.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Türk Nefroloji Diyaliz ve Transplantasyon Dergisi
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Scopus Q Değeri
Cilt
26
Sayı
2
