| Objective To evaluate the associated factors of hydration status(overhydration,OH)in peritoneal dialysis(PD)patients,and investigate the prevalence left ventricular hypertrophy(LVH)in patients with different hydration status and the associated factors of LVH.Method 1.Eligible PD patients in Renji Hospital,Shanghai Jiao Tong University School of Medicine were enrolled.Hydration status(overhydration,OH)was measured by bioimpedance spectroscopy using the body composition monitor(BCM).Enrolled patients were divided into normohydrated group(OH?1.1L)and overhydrated group(OH>1.1L).Multivariate linear regression was used to analyze the independent associated factors of hydration status in PD patients.2.Eligible PD patients with echocardiography in Renji Hospital,Shanghai Jiao Tong University School of Medicine were enrolled.The enrolled patients were divided into normal hydration group,overhydration group.The LVM and LVMI were compared between the two groups,Pearson's correlation and Spearman's correlation were performed to identify the relationship between OH and cardiac status.3.113 eligible PD patients with echocardiography in Renji Hospital,Shanghai Jiao Tong University School of Medicine were enrolled.Demographic data of patients were collected and biochemical parameters were measured.Hydration status index overhydration(OH)was measured by bioimpedance spectroscopy,and LVH was diagnosed by echocardiography.Logistic regression was used to analyze the independent associated factors of LVH in PD patients.Result 1.A total of 147 PD patients aged 58.52(48.13,64.96)years with median PD duration 43.03(13.27,72.33)months were enrolled in present study.Among them,90(61.2%)patients were males and 21(14.3%)comorbided with diabetes mellitus.107(72.8%)patients in present study were overhydrated(OH>1.1L).Compared to those with normal hydration status,the overhydrated patients had higher proportion of diabetes,higher BSA,Charlson comorbidity score,brain natriuretic peptide(BNP),4h D/Pcr,24 h dialysate protein and lower tKt/V,serum albumin than that in the normal hydrated patients(all P<0.05).Multivariate linear regression showed that diabetes mellitus(?=1.494,P<0.001),higher 4h D/Pcr(?=5.170,P<0.001)and lower serum albumin level(?=-0.125,P=0.001)were the independent associated factors of OH.2.A total of 113 PD patients aged 58.98(48.89,65.33)years with median PD duration 46.20(18.08,72.75)months were enrolled in present study.Compared to the normal hydration group,the overhydration patients had higher 4hD/Pcr?BNP?LVEDD?LVDs?IVST?LVPWT?LVM?LVMI and the prevalence of LVH,and lower serum albumin(all P<0.05).OH was positively and significantly correlated with LVEDD?LVDs?IVST?LVPWT?LVM?LVMI(all P<0.05).3.A total of 113 PD patients aged 58.98(48.89,65.33)years with median PD duration 46.20(18.08,72.75)months were enrolled in present study.OH>1.1L was detected in 80(70.8%)patients.Among them,34(42.5%)had subclinical overhydrated(SCOH).In the normal hydrated(OH ? 1.1L)patients,LVH was detected in 10(30.3%)patients.While LVH was diagnosed in 33(71.7%)clinical overhydrated(COH)patients and 17(50%)SCOH patients.Compared to those without LVH,patients with LVH showed higher proportion of ACEI/ARB,higher systolic pressure,4hD/Pcr,BNP,LVMI and OH(all P<0.05),lower hemoglobin,serum albumin and EF(all P<0.05).Multivariate Logistic regression showed that OH(OR 1.730,95%CI 1.274~2.348,P<0.001),hemoglobin(OR 0.965,95%CI 0.940~0.991,P=0.008)were the independent associated factors of LVH.Conclusion 1.Overhydration is common in PD patients.Diabetes mellitus,higher 4hD/Pcr and lower serum albumin were independently associated with hydration status in PD patients.2.OH was positively and significantly correlated with LVEDD?LVDs?IVST?LVPWT?LVM?LVMI.3.LVH is widespead in PD patients,especially in patients with overhydration.OH and hemoglobin were the independent associated factors of LVH. |
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