| Clinical Usefulness of Bioimpedence Analysis in
Determining Volume Status in CAPD Patients |
| Ho Cheol Song, M.D., Kyu Re Joo, M.D., Yu Ah Hong, M.D., Hyun Jeong Lee, M.D. , Yong Gyun Kim, M.D. Seok Joon Shin, M.D., Byung Soo Kim, M.D. , Young Ok Kim, M.D., Yong Soo Kim, M.D. and Euy Jin Choi, M.D. |
| Department of Internal Medicine, College of Medicine The Catholic University of Korea, Seoul, Korea |
| 원저 : 복막투석 환자에서 체액량 결정을 위한
Bioimpedance Analysis의 유용성 |
| 송호철·주겨레·홍유아·이현정·김용균·신석준·김병수·김영옥·김용수·최의진 |
| 가톨릭대학교 의과대학 내과학교실 |
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| Abstract |
Purpose
: Determination of accurate body fluid is essential for treating hypertension in end stage renal
disease patients undergoing dialysis. However, the determination of dry body weight based on clinical
assessment has low sensitivity and specificity. This study was done in order to examine the usefulness
of bioimpedance analysis in determining the volume of CAPD patients.
Methods
: Twenty-four hours ambulatory blood pressure and plasma concentrations of atrial natriuretic
peptide (ANP) were measured and peritoneal equilibration test (PET) were obtained from 32 stable
CAPD patients. Patients were divided into three groups; patients with normal blood pressure (group
A, 11 people), and patients who have hypertension but controlled (under 130/80mmHg) with anti-hypertension
medication (group B, 9 people), patients who have high blood pressure (over 130/80
mmHg) with 2 more anti-hypertension medication (group C, 12 people). We measured normalized extracellular
fluid (nECF), extracelluar fluid/intracellular fluid ratio (ECF/ICF) and extracellular fluid/total body
water (ECF/ TBW) of each group by using bioimpedance analysis (BIA) and compared the results of
each group. We also compared the values of nECF, ECF/ICF, ECF/TBW indices from patients with those
from normal renal function people.
Result : Thirteen men and nineteen women participated in this test. Their mean age was 53±12 years
and mean duration of CAPD was 49±38 months. Among three groups, plasma ANP level in group
C (53.1±13.6 pg/mL) was significantly higher than the level in group A (10.3±7.2 pg/mL) and B
(13.7±8.1 pg/mL) (p<0.05). The values of nECF, ECF/ICF, ECF/TBW that measured by BIA in group
C was significant higher than the values in group A and B, but the values in group A and B were not
significant different. The values of nECF, ECF/ICF, ECF/TBW from patients with normal kidney function
were not different from those of group A and B, but the values were significantly lower than the values
in group C (p<0.05). Plasma ANP level was correlated with nECF, ECF/ICF, ECF/TBW (p<0.05) value.
Plasma ANP and nECF, ECF/ICF, ECF/TBW was not influenced different PET result.
Conclusion
: BIA is considered as a useful standard to predict the volume status in CAPD patients.
In the future, prospective studies are demanded for clinical application. |
| Key Words:
Peritoneal dialysis, Biolectric impedance, Blood volume, Hypertension |
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