实际体重相较于干体重偏离度评估腹膜透析患者容量负荷的研究OA

Objective To explore the application value of the deviation of actual body weight from dry body weight in fluid overload of peritoneal dialysis(PD)patients.Methods Patients who received PD at Wuhan Hospital of Traditional Chinese and Western Medicine from June 2020 to December 2022 were retrospectively selected as the research subjects.Basic characteristics and biochemical data of patients were collected.Patients were grouped based on the deviation of their actual body weight from dry body weight.The validity of using the over-hydration(OH)value as a diagnostic criterion was verified.The study investigated the relationships between deviation and laboratory parameters and dialysis adequacy,and analyzed the impact of fluid overload on the occurrence of cardiovascular and cerebrovascular events and patient survival.Results A total of 118 PD patients were included.Using the OH value as the diagnostic standard,the distribution of the deviation of actual body weight from dry body weight showed a gradient increase across different volume status groups.Receiver operating characteristic curve analysis identified the optimal cut-off value for discriminating fluid overload as 2.015％[area under the curve(AUC)=0.982]and for severe fluid overload as 4.165％(AUC=0.979).The deviation was negatively correlated with serum albumin,total Kt/V,residual renal function,and residual urine volume,positively correlated with Charlson comorbidity index score,C-reactive protein,and blood pressure(P<0.05).Male,low serum albumin,diabetes,high systolic blood pressure,and low residual urine volume were independent risk factors for increased deviation(P<0.05).The survival rate of patients in experimental group B was significantly lower than that in control group and experimental group A(P<0.05),and the incidence of cardiovascular and cerebrovascular events was significantly higher than that in control group and experimental group A(P<0.05).Conclusion Deviation of actual body weight from dry body weight is a reliable indicator for assessing fluid overload in PD patients.Based on its high specificity,high positive predictive value,and feasibility,cutoff values of 2％and 5％can be used to distinguish fluid overload and severe fluid overload,respectively.Patients with fluid overload have a higher incidence of cardiovascular and cerebrovascular events and a lower survival rate.