| Changes of Intracellular Water by Hemodialysis in Diabetic and Non-diabetic ESRD Patients: Analysis with MF-BIA |
| Se-Na Jang, M.D., Hyung Wook Kim, M.D., Young Shin Shin, M.D. and Dong Chan Jin, M.D. |
| Department of Internal Medicine, College of Medicine, The Catholic University of Korea |
| 원저 : 당뇨병 및 비당뇨병 말기신부전 환자의 혈액투석에 의한 세포내 수분의 변화: 다주파수 생체전기 임피던스 (MF-BIA)를 이용한 분석 |
| 장세나, 김형욱, 신영신, 진동찬 |
| 가톨릭대학교 의과대학 내과학교실 |
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| Abstract |
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Purpose:During hemodialysis, various methods are used to evaluate adequate water removal; however, few of them are currently clinically applicable. To evaluate the differences of body fluid changes, we have compared changes of ICW (intracellular water) and ECW (extracellular water) before and after hemodialysis in diabetic and non-diabetic patients with MF-BIA. Also various factors influencing in this transcellular body fluid shift were evaluated.
Methods:TBW (total body water), ICW, ECW were measured before and after hemodialysis by using MF-BIA in 85 stable maintenance hemodialysis patients in a university hospital. Among these patients, 30 patients (mean age 55.6±12.4 year-old, average dialysis duration 26 months) were diabetic, while 55 patients (mean age 47.1±13.0 year-old, average dialysis duration 69 months) were non-diabetic.
Results:ECW/TBW in diabetic and non-diabetic patients were 0.338±0.02, 0.334±0.02, respectively. There was no significant difference between two groups. There were also no significant differences in the sex, age, duration of dialysis, BMI, hemoglobin, total protein, osmolarity of ICW loss/TBW removal. But there was a significant positive correlation between the increase in ultrafiltration volume (UFV:%) and ICW loss in diabetic patients (R=0.51, p=0.019); however, such correlation was not observed in non-diabetic patients.
Conclusion:We found that ICW of diabetic patients moved to extracellular spaces even before achieving appropriate dry body weight or less amount of fluid was removed compared to non-diabetic patients. This finding might imply diabetic ESRD patient has relatively low cellular membrane integrity and oncotic pressure maintenance ability to physical transmembrane pressure. |
| Key Words:
Dialysis, Diabetes mellitus, Bioelectrical impedance |
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