ABSTRACT
Bioelectrical impedance measurement technology is a non-invasive detection technology for extracting human physiological and pathological information. The analysis method of the relationship between bioimpedance and human physiological parameters is an important part of this technology. In order to calculate the internal and external liquid volume of human cells more accurately, based on the Moissl equation for calculating the internal and external fluid volume of human cells, a segmented human bioimpedance spectrum measurement model and an improved calculation method of intracellular and external fluid capacity were proposed. The measurement and calculation experiments of the intracellular and extracellular fluid volume before and after the human body's water intake were designed and compared with the Moissl calculation method. The results show that the improved calculation method can calculate the intracellular and extracellular fluid volumes more effectively, and the relative error is less than 5%, which may provide new ideas or more accurate methods for the analysis of human body components, facilitating the diagnosis and treatment of diseases.
Subject(s)
Humans , Body Water , Electric Impedance , Extracellular Fluid , Intracellular FluidABSTRACT
Objective: To investigate the role of common clinical indicators in volume assessments of peritoneal dialysis (PD) patients. Methods: Eligible PD patients in Renji Hospital, Shanghai Jiao Tong University School of Medicine from Nov. 2016 to Nov. 2017 were enrolled. Demographic data of patients were collected and clinical parameters were measured. Hydration status index overhydration (OH) was measured by bioimpedance spectroscopy, and the association between clinical indicators and OH was analyzed. Results: A total of 200 PD patients aged 56.3±13.8 years with median PD duration of 46.6 months were enrolled in the study. Among them, 117 (58.5%) patients were males and 42 (21.0%) patients were diabetic. 141 (70.5%) patients in the present study were overhydrated (OH>1.1 L). Compared to those with normal hydration, the overhydrated patients had higher blood pressure, more obvious edema and higher brain natriuretic peptide (BNP) level (P<0.05). In the overhydrated patients, 51 (36.2%) patients had normal blood pressure, 67 (47.5%) patients had no edema and 46 (32.6%) patients had BNP less than 100 pg/mL. In the normal hydrated patients, 20 (33.9%) patients had high blood pressure, 8 (13.6%) patients had edema and 1 (1.7%) patient had BNP higher than 400 pg/mL. Systolic pressure and BNP level were both correlated with OH positively (systolic pressure r=0.361, P=0.001; BNP r=0.615, P=0.000). The patients who had more obvious edema also had higher OH (P=0.000). Conclusion: Blood pressure, edema and BNP are closely associated with the hydration status, but only one of these clinical indicators can not accurately reflect the hydration status in all PD patients. Combination of different indicators may be useful in evaluation of hydration status in PD patients.
ABSTRACT
Objective · To explore influencing factors associated with the hydration status in peritoneal dialysis (PD) patients.Methods · Eligible PD patients treated in Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine from September 2016 to January 2017 were enrolled.Demographic data of patients were collected and biochemical indexes were measured.Their peritoneal transport characteristics and dialysis adequacy were evaluated.Hydration status index overhydration (OH) value was measured with bioimpedance spectroscopy.Multivariate linear regression was used to analyze the independent factors associated with the OH.Results · A total of 147 PD patients with a median age of 58.52 years and a median PD duration of 43.03 months were enrolled.Of them,90 (61.2％) were male,21(14.3％) were accompanied by diabetes mellitus,and 107 (72.8％)were overhydrated (OH＞1.1L).Compared to those with normal hydration status (OH ≤ 1.1 L),the overhydrated patients had higher proportion of diabetes,BSA,Charlson comorbidity score,brain natriuretic peptide (BNP),4 h D/Pcr,and 24 h dialysate protein,and lower tKt/V,serum albumin than the normal hydrated patients (all P＜0.05).Multivariate linear regression showed that comorbid diabetes mellitus (P=0.000),higher 4h D/Pcr (P=0.000),and lower serum albumin level (P=0.001) were independent relevant factors for the increase of OH.Conclusion· Overhydration is common in PD patients.Comorbid diabetes mellitus,higher 4 h D/Pcr,and lower serum albumin are independent relevant factors for the hydration status in PD patients.
ABSTRACT
One of the goals of hemodialysis is to maintain normal hydration status in ESRD patients.Pre hemodialysis systolic blood pressure is usually used as a clinical parameter of hydration status and to set ultrafiltration rate before Hd. It is unclear how much pre-Hd SBP correlated with hydration status. The aimwas to determine correlation between pre-Hd SBP and hydration status before Hd. An observational correlation study was performed in two dialysis centers in Santiago, Chile, from January-June, 2011. Adult patients inHd for at least three months, who gave their informed consent were included. Patients with pacemaker,amputee, hospitalized and metallic prostheses were excluded. Total-body water and over hydrated were assessed with bioimpedance spectroscopy before the first and third dialysis session of the week. Pre-Hd SBP,pre-Hd body weight, pre-Hd TBW and pre-Hd OH, were analyzed using Pearson correlation and linear regressionmodel. 96 measurements were assessed, 52 % were male with median age 59.5 years. The correlationbetween pre-Hd SBP and pre-Hd overhydration was r=0.33, and total body water r=0.15, with a predictedvalue, R2=0.10 and R2 =0.14 respectively. Pre-Hd SBP had low correlation with pre-Hd hydration status and by itself, is not a reliable parameter to set ultrafiltration rate before Hd. Nevertheless Pre-Hd body weight predicted in 70 % the pre-Hd TBW.
Uno de los objetivos de la hemodiálisis es mantener la hidratación normal en pacientes ESRD. La presión arterial sistólica pre hemodiálisis, es usualmente utilizada como parámetro clínico del estado de hidratación y para fijar la velocidad de ultrafiltración antes de la hemodialisis. No está claro cuanto se correlacionan la presión arterial sistólica prehemodialysis con el estado de hidratación. El objetivo fue determinar la correlación entre la PAS prehemodiálisis y el estado de hidratación antes de Hd. Se realizó un estudio de correlación observacional en dos centros de diálisis de Santiago de Chile, de Enero a Junio de 2011. Se incluyeron pacientes adultos en HD durante al me-nos tres meses que dieran su consentimiento informado. Se excluyeron los pacientes con marcapasos, amputados, hospitalizados y pró-tesis metálicas. El agua corporal total y el exceso de hidratación se evaluaron con espectroscopia 1030 de bioimpedancia antes de la primera y tercera sesión de diálisis de la semana. Pre-Hd PAS, pre-Hd peso corporal, pre-Hd ACT y pre-Hd OH, se analizaron utilizando el modelo de correlación y regresión lineal de Pearson. Se evaluaron 96 mediciones, 52% eran hombres con edad media 59, 5 años. La correlación entre la PAS pre-Hd y la sobrehidratación pre-Hd fue r=0, 33 y agua corporal total r=0, 15, con un valor predicho, R2= 0, 10 y R2 = 0, 14 respectivamente. Existe baja correlación entre la PAS Pre-Hd con el esta-do de hidratación pre-Hd y por lo mismo, no es un parámetro confiable para establecer la tasa de ultrafiltración antes de Hd. Sin embargo, el peso corporal Pre-Hd predijo en un 70% el agua corporal total pre-Hd.