References

nid

Нефрология и диализ

Nephrology and Dialysis

1680-44222618-9801

Российское диализное общество

nid-582

Research Article

ОРИГИНАЛЬНЫЕ СТАТЬИ

ORIGINAL ARTICLES

Состояние водного статуса у больных, получающих различные виды заместительной почечной терапии

State of water status in patients receiving different types of renal replacement therapy

Рахматуллина

Л. Н.

Rakhmatullina

L. N.

Leisan_83@mail.ru

Гуревич

К. Я.

Gurevich

K. Y.

noemail@neicon.ru

Северо-Западный государственый медицинский университет им. И.И. Мечникова, Санкт-Петербург, РоссияРоссияNorthwestern State Medical University Mechnikov, Saint-Petersburg, RussiaRussian Federation

Fresenius Medical Care, Санкт-Петербург, РоссияРоссияFresenius Medical Care, Saint-Petersburg, RussiaRussian Federation

2013

19092024

1517486

2024

Рахматуллина Л.Н., Гуревич К.Я.

Rakhmatullina L.N., Gurevich K.Y.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://journal.nephro.ru/jour/article/view/582

Цель исследования – оценка водного статуса у диализных больных в течение года наблюдения на основе клинических, лабораторных, эхо-кардиографических показателей и данных биоимпедансного анализатора Body Composition Monitor (БИА ВСМ). У 87 диализных больных на разных видах заместительной почечной терапии проведена сравнительная оценка уровня гидратации в каждой группе, а также между диализными группами. Больные на перитонеальном диализе (ПД) были более гипергидратированы, чем на гемодиализе (ГД) ( p < 0,05), имели более высокие цифры артериального давления ( p < 0,05), принимали большее количество гипотензивных препаратов ( p < 0,05). В течение года на фоне коррекции «сухого веса» отмечено снижение среднего артериального давления в обеих диализных группах, количества гипотензивных препаратов в группе гемодиализа ( p < 0,05) без увеличения частоты интрадиализных осложнений. Гидратация у ПД больных зависела от пола, диализного стажа, объема суточного диуреза и влияла на артериальное давление, количество гипотензивных препаратов, процент внеклеточной жидкости, частоту концентрической гипертрофии левого желудочка и диастолической дисфункции, а также на толщину задней стенки левого желудочка ( p < 0,05). У ГД больных уровень гидратации зависел от пола, процента внеклеточной жидкости, массы тела, индекса массы тела, тощей и жировой массы тела, объема ультрафильтрации за сеанс и влияла на частоту диастолической дисфункции, массу миокарда ( p < 0,05). Мультичастотная биоимпедансометрия представляется надежным методом определения водного статуса в диализной практике.

The aim of the study was to assess the hydration status in dialysis patients during a year of observation on the basis of clinical, laboratory, echocardiographic parameters and data of bioimpedance analysis with Body Composition Monitor. A comparative assessment of the level of hydration in each group of patients and between dialysis groups was made in 87 dialysis patients with different types of renal replacement therapy. The patients on peritoneal dialysis were more hyperhydrated than haemodialysis patients ( p < 0,05), had higher blood pressure ( p < 0.05), received more hypotensive drugs ( p < 0,05). The decline of mean arterial blood pressure had been reported in both groups due to the "dry weight" correction. In haemodialysis group a decrease in amount of hypotensive drugs without intradialysis complications increase was observed ( p < 0,05). Hydration in PD patients depended on gender, dialysis vintage, residual diuresis and affected on arterial blood pressure, number of hypotensive drugs, the percentage of extracellular fluid, frequency of concentric left ventricular hypertrophy and diastolic dysfunction, as well as on the thickness of the posterior wall of the left ventricle ( p < 0,05). In haemodialysis patients a hydration level was depended on the gender, the percentage of extracellular fluid, body mass, body mass index, lean and fat mass, volume ultrafiltration per session and affected the frequency of diastolic dysfunction, myocardial mass ( p < 0,05). The multifrequency bioimpedance examination seems to be a reliable method for evaluation of the water status in dialysis practice.

water statushaemodialysisperitoneal dialysisbioimpedancehydrationmean blood pressureextracellular waterbody composition monitorводный статусгемодиализперитонеальный диализбиоимпедансометриягидратациясреднее артериальное давлениевнеклеточная водамонитор состава тела

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The authors declare that there are no conflicts of interest present.