| Objective:To explore the application of Direct Segmental Multi-frequency Bioelectrical Impedance Analysis(DSM-BIA)in maintenance hemodialysis patients(MHD)with diabetic kidney disease.Methods:95 MHD patients in stable condition with regular hemodialysis were randomly selected from the blood purification center of the First Affiliated Hospital of Kunming Medical University.The general clinical data of the patients were collected.These patients were divided into diabetic kidney disease group(DKD group)and non-diabetic kidney disease group(NDKD group)according to whether their primary disease is diabetic kidney disease(DKD)or not.The total/segment body compositions of the patients was measured by Inbody S10 body composition analyzer after hemodialysis.The parameters of total body composition included total body water(TBW),intracellular body water(ICW),extracellular body water(ECW),extracellular body water/total body water(ECW/TBW),total body water/free fat mass(TBW/FFM)and 50kHz phase angle(50kHz PA).The parameters of segment body composition included left arm(LA),right arm(RA),trunk(TR),left leg(LL)and right leg(RL),body water,ECW/TBW,soft lean mass and 50kHz PA.Laboratory examination of these patients were conducted including plasma albumin(ALB),total cholesterol(TC),blood creatinine(Scr)and urea nitrogen(BUN).Urea clearance index(Kt/V)was used to evaluate dialysis adequacy.Kt/V≥1.2 means dialysis adequacy and Kt/V<1.2 means dialysis inadequacy.The general clinical data,laboratory examinations,dialysis adequacy and the parameters of total/segment body compositions in the two groups were compared.SPSS 19.0 statistical software was used for statistical analysis.P<0.05 indicated that the difference was statistically significant.Results:1.60 male and 35 female within the 95 MHD patients enrolled in our study were 28 patients in the DKD group and 67 patients in the NDKD group.MHD patients with DKD within all 95 MHD patients was 29.47%.The comparison of the data in the two groups showed that there was no statistically significant difference in age,gender,dry body mass,and body mass index(BMI)(P>0.05).2.The comparison of laboratory examinations between the DKD group and the NDKD group showed that ALB was statistically significant difference(P<0.05),and TC,Scr and BUN were not statistically significant difference(P>0.05)3.The comparison of dialysis adequacy between the DKD group and the NDKD group exhibited that Kt/V was statistically significant difference(P<0.05).4.The total body composition compared the DKD group with the NDKD group,ECW,ECW/TBW,VFA,TBW/FFM,and 50kHz PA were statistically significant differences(P<0.05)and the other parameters were not statistically significant differences(P>0.05).5.The comparison of segment body composition data between the DKD group and the NDKD group,the differences in ECW/TBW and 50kHz PA in the LA,RA,TR,LL,and RL were statistically significant(P<0.05).The difference in the body water only in LL was statistically significant(P<0.05).The lean mass in all segments was not statistically significant difference(P>0.05).Conclusions:1.MHD patients with DKD had the poor nutritional status,less volume load and dialysis inadequacy.2.The water content measured by DSM-BIA indicated that the volume load of MHD patients with DKD was mainly distributed in extracellular fluid,and mainly in the left lower extremity.3.The 50kHz phase angle measured by DSM-BIA method suggested that the MHD patients with DKD had poor nutritional status and disease prognosis.4.DSM-BIA method was used to measure the muscle mass in the MHD patients with DKD,which is recommended to perform body composition determination in the ideal dry body mass for obtaining more accurate muscle mass. |
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