Relationship Between Fluid And Hypertension In Diagnosed By Water And Dampness Retention Hypertension Peritoneal Dialysis Patients

Objective:Hypertensionis highly prevalent among CAPD patients and is a major risk factor for cardiovascular disease,including stroke,coronary heart disease,heart failure.And cardiovascular disease is a leading cause of death in patients with CAPD.The present study was conducted to investigate the relationship between volume overload and hypertension in water and dampness retention patients with continuous ambulatory peritoneal dialysis(CAPD)and effect of dietary salt restricted on blood pressure(BP)and arterial stiffness.Method:1.Based on the blood pressure in three consecutive months,86 stable CAPD patients were divided into two groups:persistent hypertensive(PH, n=39)and persistent normotensive(PN,n=47).Fluid status was evaluated by biompedance analysis(BIA)and PWV was measured by an automatic processor(Complion Colson AS,Paris,France).2.Based on the blood pressure in three consecutive months,67 stable CAPD patients were studied.To varying degrees by edema were divided into three groups:1.non-edema group(n=28),2.mild-edema group(n=21),3.serious edema group(n=18).The fluid,sodium removal and PWV,ABI, PWV,ABI,pulse pressure(PP),mean blood pressure(MBP),heart rate(HR) were measured.The total extracellular water(ECW),interacellular water(ICW)and total body water(TBW)by biompedance analysis(BIA).3.Based on the blood pressure in three consecutive months,76 stable CAPD patients were randomly divided into LS group(daily salt intake 3g)and NS group(daily salt intake 6g)and restricted for 3months. Their body weight,extracellular water(ECW),interacellular water(ICW) and total body water(TBW),blood pressure(BP),PWV,ABI,pulse pressure(PP),mean blood pressure(MBP),heart rate(HR)and urine volume and ultrafiltration volume and the syndrome of traditional Chinese medicine were measured before and after the dietary restriction.Result:1.ECW,nECW(standard by weight and height)and TBW of PH group was significantly higher than PN group(P＜0.05).PWV,ABI,PP and MBP in PN group were significantly(P＜0.05)less than PH group.And the heart rate was not significantly different between two groups.2.A significant correlation was found between ECW and systolic,Diastolic Blood Pressure and mean blood pressure(P＜0.05), and a negative correlation was found between ECW,E/T,ICW,E/I and PWV,ABI and PP(P＜0.05).3.ECW in serious edema group was significantly higher than non-and mild-edema group(P=0.000).Total body water,nECW,E/T,E/I,24h fluid removal,24h sodium removal and systolic blood pressure were statistically significant between serious edema group and non-edema group(P＜0.05).4.After 3-months study period,ICW,TBW,E/T,E/I,SBP,DBP,PP and MBP were decreased significantly(P＜0.05)in LS and NS group.The syndrome of traditional Chinese medicine in LS group improved significantly (P＜0.05)after the study period.The prevalence of hypertension in LS group(24.4%)and NS group(51.9%)were significantly(P＜0.05)lower than before.Conclusion:There is a positive correlation between volume status and blood pressure.Most of the CAPD patients are fluid overloaded and that dietary salt restriction maybe an effective way to control volume and pressure.And significant improves the syndrome of traditional Chinese medicine and arterial stiffness status in water and dampness retention hypertension PD patients.