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学科主题: 临床医学
题名:
Why is there significant overlap in volume status between hypertensive and normotensive patients on dialysis?
作者: Cheng, Li-Tao1; Tian, Jun-Ping1,2; Tang, Li-Jun1,3; Chen, Hui-Min1,4; Gu, Yue1; Du, Feng-He2; Wang, Tao1
关键词: hypertension ; volume overload ; extracellular water ; peritoneal dialysis, volume status ; hemodynamics ; stroke volume ; cardiac output ; total peripheral resistance
刊名: AMERICAN JOURNAL OF NEPHROLOGY
发表日期: 2008
DOI: 10.1159/000113727
卷: 28, 期:3, 页:508-516
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Urology & Nephrology
研究领域[WOS]: Urology & Nephrology
关键词[WOS]: LEFT-VENTRICULAR HYPERTROPHY ; BLOOD-PRESSURE CONTROL ; STAGE RENAL-DISEASE ; HEMODIALYSIS-PATIENTS ; HEMODYNAMIC-CHANGES ; SODIUM RESTRICTION ; WATER ; ASSOCIATION ; VALIDATION ; NUTRITION
英文摘要:

Background/Aim: Volume overload is believed to play a pivotal role in the pathogenesis of hypertension in dialysis patients. Although the extracellular water (ECW) content in hypertensive dialysis patients was significantly higher than in normotensive dialysis patients on the whole, there was considerable overlap in ECW between the two groups. Little is known about the hemodynamic characteristics in subgroups of patients with normotension but a high volume (HV) status or with hypertension but a normal volume (NV) status. We investigate the overlap in ECW between controlled and uncontrolled hypertension in dialysis patients. Methods: Fifty-two patients (mean age 62 years, 26 males and 26 females) on peritoneal dialysis were enrolled into this study. The ECW was assessed by bioimpedance analysis and normalized by individual height in meters (NECW). The mean value of NECW in both sexes was arbitrarily set to define NV status (lower than mean value) or HV status (higher than mean value). All patients were thus divided into four subgroups: controlled hypertension with NV (CHT-NV), controlled hypertension with HV (CHT-HV), uncontrolled hypertension with NV (UHT-NV) and uncontrolled hypertension with HV (UHT-HV). The stroke volume, cardiac output and total peripheral resistance were echocardiographically measured and their respective indices were calculated. Results: There were 12 (23%), 8 (15%), 14 (27%) and 18 (35%) patients in the CHT-NV, CHT-HV, UHT-NV and UHT-HV subgroups, respectively. The four subgroups were matched for sex, diabetes and age. The NECW in the CHT- HV group was higher than that in CHT-NV and UHT-NV groups (p < 0.01), but was comparable with that in the UHT-HV group. The stroke volume and cardiac output indices in the CHT-HV group were not significantly different from those in the CHT-NV and UHT-NV groups. The total peripheral resistance index in the CHT-HV group was lower than that in UHT-NV and CHT-NV groups (p < 0.05), but was comparable to that in the UHT-HV group. There was no difference in heart rate among the four groups. Conclusions: The overlap in ECW between controlled hypertension and uncontrolled hypertension in dialysis patients was related to a significant difference in total peripheral resistance index, but not to significant differences in stroke volume and cardiac output indices. The CHT-HV patients were characterized by lower total peripheral resistance indices. Copyright (C) 2008 S. Karger AG, Basel.

语种: 英语
WOS记录号: WOS:000253777700018
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/57011
Appears in Collections:北京大学第三临床医学院_肾内科_期刊论文

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作者单位: 1.Peking Univ, Third Hosp, Div Nephrol, Beijing 100083, Peoples R China
2.Capital Univ Med Sci, Div Cardiol, Beijing Tiantan Hosp, Beijing, Peoples R China
3.Shandong Univ, Div Nephrol, Qilu Hosp, Jinan 250100, Peoples R China
4.Guangzhou Univ Tradit Chinese Med, Clin Coll 2, Div Cardiol, Guangzhou, Peoples R China

Recommended Citation:
Cheng, Li-Tao,Tian, Jun-Ping,Tang, Li-Jun,et al. Why is there significant overlap in volume status between hypertensive and normotensive patients on dialysis?[J]. AMERICAN JOURNAL OF NEPHROLOGY,2008,28(3):508-516.
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