Study On The Effect Of Single Dialysis Ultrafiltration Volume On The Fluid Distribution Of Patients Undergoing Maintenance Hemodialysis By Inbody

Objective:The main way for patients with end-stage renal disease(ESRD)to maintain life is hemodialysis.One of the main purposes of hemodialysis is to remove the water retention during the dialysis interphase.The purpose of this study is to research the effect of single ultrafiltration on the fluid distribution in patients with maintenance hemodialysis(MHD)using a human composition analyzer(InBody S10).Methods:A total of 136 patients undergoing maintenance hemodialysis were selected patients from the blood purification center in the Forth Affiliated Hospital of Hebei Medical University,including 32 cases of diabetic nephropathy and 104 cases of non-diabetic nephropathy.Patients were measured with total body water(TBW),extracellular water(ECW),intracellular water(ICW)and extracellular water ratio(ECW/TBW%),extracellular water/total body water-right arm(ECW/TBW-RA%),extracellular water/Total body water-left arm(ECW/TBW-LA%),extracellular water/Total body water-trunk(ECW/TBW-TR%),extracellular water/total body water-right leg(ECW/TBW-RL%),extracellular water/total body water-left leg(ECW/TBW-LL%),phase angle-right arm(PA-RA),phase angle-left arm(PA-LA),phase angle-trunk body(PA-TR),phase angle-right leg(PA-RL),the phase angle-left leg(PA-LL)and phase angle-whole body(PA-WB)before and after dialysis via InBody S10.Paired t test and Pearson correlation analysis by SPSS 21.0 software were used to analyze the influence of single ultrafiltration on the change of body fluid distribution in MHD patients,and the influence of single ultrafiltration on the change of body fluid distribution in diabetic nephropathy patients and non-diabetic nephropathy patients.Results:1.Compared with before dialysis,TBW、ECW、ICW、ECW/TBW%、PA-WB and other indexes were significantly changed after dialysis(P<0.05).There was no statistical significance in the changes of PA-LA、PA-TR before and after dialysis in diabetic nephropathy patients patients,while the other indexes were significantly changed(P<0.05).After dialysis,all indexes of non-diabetic nephropathy patients were significantly changed(P<0.05).2.Univariate correlation analysis showed that the ultrafiltration volume of MHD patients on a single dialysis was closely related to the changes of TBW、 ECW、 ICW、ECW/TBW% and PA-WB before and after dialysis(P<0.05),and the influence intensity from large to small were ECW、TBW、ICW、PA-WB.The ultrafiltration volume of single dialysis in diabetic nephropathy patients was closely related to the changes of TBW、ECW and ICW before and after dialysis(P<0.05),and the the influence intensity from large to small were ECW、TBW 、ICW.The ultrafiltration volume of single dialysis in patients with non-diabetic nephropathy was closely related to the changes of TBW、ECW、ICW and ECW/TBW% before and after dialysis(P<0.05),and the influence intensity from large to small were ECW、TBW、ECW/TBW%、ICW.Conclusions:1.After single ultrafiltration dialysis,TBW、ECW、ICW and the water content of each segment in MHD patients were significantly decreased.The dehydration of MHD patients was mainly from ECW.2.PA-RA、PA-LA、PA-TR、PA-RL、PA-LL and PA-WB were significantly changed after hemodialysis in MHD patients,phase angle may be a potential indicator to guide the volume assessment of MHD patients.3.All indexes of diabetic nephropathy before and after dialysis were significantly changed except PA-LA、PA-TR,the other measurement indexes of Inbody can be used to guide the volume assessment of dialysis patients with diabetic nephropathy.