Application Of Bioelectrical Impedance Analysis In Improving Fluid Overload And Cardiac Function In Peritoneal Dialysis Patients

Objective: Cardiovascular disease caused by fluid overload is the main cause of death and high rehospitalization rate of peritoneal dialysis patients.According to electrical impedance analysis,New York cardiac function classification and cardiac Doppler ultrasound,evaluate the systemic fluid load state and cardiac function of peritoneal dialysis patients,find and correct the fluid overload in time to reach the normal level of systemic fluid load state,so as to provide scientific guidance for the improvement of cardiac function and fluid management of patients,reduce the incidence of cardiovascular events.Methods: The peritoneal dialysis patients with chronic kidney disease stage 5 who were followed up in the nephrology department of Qinghai University Hospital for a long time from November 2020 to November 2021 were selected.The values of intracellular fluid,extracellular fluid,total body water volume,phase angle and edema index in the dialysis patients were measured by bioelectrical impedance analysis,the fluid load of the patients was evaluated,and the dialysis patients with fluid overload were selected for New York cardiac function classification and cardiac Doppler ultrasound examination,The ejection fraction,left ventricular short axis shortening index,left ventricular end diastolic diameter,ventricular septal thickness and left ventricular posterior wall thickness were measured,and the left ventricular mass index was calculated to evaluate cardiac function;Regularly use bioelectrical impedance analysis to evaluate the patients’ fluid overload status,correct the fluid overload in time until the patients’ fluid overload status returns to the normal level and remains stable for 3 months,and perform New York Heart Function Classification and Doppler echocardiography again;At the same time,general data such as urine volume,height,weight,blood pressure and ultrafiltration volume were recorded.Finally,through the self-control of cardiac function,bioelectrical impedance analysis and general clinical data of peritoneal dialysis patients before and after fluid adjustment,to explore the role of bioelectrical impedance analysis in the improvement of fluid overload and cardiac function in peritoneal dialysis patients.Results:(1)There were significant differences in ejection fraction,left ventricular short axis shortening rate,left ventricular mass index and New York cardiac function grade between before and 3 months after evaluation(P < 0.001).(2)The extracellular fluid,edema index and phase angle of the patients were improved before evaluation and1,2 and 3 months after evaluation(P < 0.001).(3)Compared with 3 months after evaluation,the urine volume increased,body weight decreased,and the difference was statistically significant(P < 0.001).Conclusion: 1.Monitoring and correcting the fluid overload of peritoneal dialysis patients in real time through bioelectrical impedance analysis can improve the general condition of peritoneal dialysis patients.2.Bioelectrical impedance analysis can correct the fluid overload of peritoneal dialysis patients,so as to improve the cardiac function of peritoneal dialysis patients,but it can not prevent the progress of left ventricular hypertrophy.3.Monitoring the whole body water load of peritoneal dialysis patients in real time based on bioelectrical impedance analysis can benefit peritoneal dialysis patients and can be popularized and applied in nephrology.