Assessment of volume status with cardiovascular risk factors in hemodialysis patients

INTRODUCTION: Chronic fluid overload is a common issue in patients undergoing hemodialysis. In present study, we aimed to investigate fluid volume parameters by bioimpedance analysis (BIA) and their relationship to hemodynamic parameters as systolic and diastolic blood pressure, pulse wave velocity (PWv), PP, cardiac index (CI) and cardiac output (CO) in patients ongoing hemodialysis.
METHODS: One hundred end stage renal disease patients who were medically stable and undergoing dialysis treatment for at least 3 months were enrolled to the study. Body compositions were analyzed with the BIA technique (BCM, Fresenius) that estimates systolic and diastolic blood pressure, body mass index (BMI) lean tissue index (LTI), extracellular volume (ECW), intracellular volume (ICW), lean tissue mass (LTM) and phase angle levels. PWv, pulse pressure, CI, CO, systolic pressure augmentation (AIx) and total vascular resistance (TVR) were evaluated with PWv analysis monitor (Mobil-O-Graph).
RESULTS: The mean age was 47.5 ± 16.2. Ultrafiltration volume and overhydration frequency were positively correlated with systolic blood pressure, ECW, ICW, BMI (p<0.05) and hemodynamic parameters as PWv, PP, CO, TVR, CI and AIx (p<0.001), and negatively correlated with LTI (p <0.05). PP, CO, TVR, CI, AIx, Kt/V, E/I and phi50 were the predictors of pulse wave velocity (p<0.05). Systolic blood pressure, PP, CO, TVR, CI, AIx, PWv, ECW, ICW and E/I were the predictors of overhydration (p<0.001).
DISCUSSION AND CONCLUSION: Present study concluded that overhydration is associated with increased PWv, systolic blood pressure, PP and vascular resistance

Hemodiyaliz hastalarýnda kardiyovaskuler riskin belirlenmesinde volüm durumunun rolü

GÝRÝÞ ve AMAÇ: Kronik sývý yükü hemodiyalize giren hastalarda sýk karþýlaþýlan bir sorundur. Bu çalýþmada, hemodiyalize giren hastalarda biyoimpedans analizi (BÝA) ile ölçülen sývý yükü parametreleri ile sistolik, diyastolik kan basýncý, nabýz dalga hýzý (PWv) nabýz basýncý, kardiyak indeks (CI) ve kardiyak output (CO) gibi hemodinamik parametreler arasýndaki iliþkinin gösterilmesi amaçlandý.
YÖNTEM ve GEREÇLER: : Son dönem böbrek hastalýðý tanýsý ile en az üç aydýr hemodiyalize giren ve medikal olarak stabil 100 hasta çalýþmaya alýndý. Biyoimpedans cihazý (BCM, Fresenius) ile yapýlan vücut kompozisyon analizinde sistolik ve diyastolik kan basýncý, vücut kitle indeksi (VKÝ), yaðsýz doku indeksi (LTI), ekstraselüler sývý volumü (ECW), intraselüler sývý volumü (ICW), yaðsýz doku kütlesi (LTM) düzeyleri belirlendi. PWv, nabýz basýncý (PP), CI, CO, sistolik basýnç artýþý (AIx) ve total vasküler direnç (TVR) nabýz dalga hýzý cihazý ile ölçüldü (Mobil-O-Graph).
BULGULAR: Ortalama yaþ 47.5 ± 16.2 idi. Ultrafiltrasyon volumü ve hipervolemi sýklýðý sistolik kan basýncý, ECW, ICW, VKÝ, (p<0.005); PWv, CO, TVR, CI ve AIx ile pozitif korele (p<0.001), LTI ile ters orantýlý saptandý (p < 0.05). Hipervolemi, prediyaliz serum sodyum düzeyinden baðýmsýzdý. PP, CO, TVR, CI, AIx, Kt/V, E/I ve faz50 açýsý PWV’nin belirleyicileri olarak saptandý (p<0.005). Sistolik kan basýncý, PP, CO, TVR, AIx, PWv, ECW, ICW ve E/I hipervoleminin belirleyicileri olarak saptandý (p<0.001).
TARTIÞMA ve SONUÇ: Çalýþmamýzda hipervoleminin nabýz dalga hýzý progresyonu, artmýþ sistolik kan basýncý, nabýz basýncý ve vasküler direnç ile iliþkili olduðu gösterilmiþtir.