Background: Volume overload is a common problem in peritoneal dialysis patients and may contribute to the high cardiac mortality in this patient population. Controlling volume status is difficult due to the lack of appropriate and accurate assessment of dry weight. This randomized, controlled study was conducted to test if the recent use of overhydration value (OH) provided by bioimpedance spectroscopy and patients’ education would help to control overhydration. Methods: 160 continuous ambulatory peritoneal patients were included in this study. All the patients were randomly allocated to 2 groups: in Group 1 the patients and their primary nurses were informed of the OH values provided by bioimpedance spectroscopy whereas in Group 2 the values were not revealed and patients’ volume was measured by the standard methods. Fluid status was evaluated by means of repeated bioimpedance analysis and clinical assessment. Urine volume, blood pressure and use of antihypertensive medications were recorded. Results: There were no differences in gender, age, diabetes, height, weight and clinical hydration status between the 2 groups at the baseline. In Group 1, OH (p < 0.05), extracellular volume and the extracellular volume to intracellular volume ratio decreased steadily during the 3-month follow-up. On the contrary, all 3 parameters increased significantly in Group 2. SBP decreased significantly in Group 1 but increased significantly in Group 2. Conclusion: Our study shows that the use of OH as determined by bioimpedance spectroscopy may facilitate volume control in peritoneal dialysis patients.
Background: Overhydration (OH) is a well-recognized problem in peritoneal dialysis (PD) patients and is an independent risk factor of mortality in this patient population. Achieving normohydration remains an important issue in dialysis therapy. The present study tries to compare clinical signs and find the optimal range for PD patients in China. Methods: A new bioimpedance spectroscopy device [body composition monitor (BCM)], which allows quantitative determination of how much the hydration status deviates from normal ranges (ΔHS), was selected. Blood pressure and ΔHS were analyzed in 92 PD patients from 1 dialysis center and compared with a matched healthy population (n = 45). Statistical analysis was performed using SPSS software, version 16.0 (SPSS Inc., Chicago, Ill., USA). Results: We took different OH values as cutoff thresholds; predictive accuracy was evaluated with sensitivity and specificity, and a receiver-operating characteristics curve and Youden’s index were adopted. Conclusion: Our data suggest that 2.0 liters is a reasonable cutoff value for ΔHS. This represents an important step towards a more objective choice of strategies for the optimal treatment of hypertension and fluid overload.
Background The clinical characteristics of Parkinson’s disease (PD) differ between men and women, and late- and early-onset patients, including motor symptoms and some nonmotor symptoms, such as cognition, anxiety, and depression. Objective To explore the features of excessive daytime sleepiness (EDS) and night-time sleep quality in PD patients of different sexes and age at onset (AAO). Methods Demographic data and clinical characteristics of 586 PD patients were collected. Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) were used to investigate the daytime drowsiness and nocturnal sleep. Multivariate logistic regression analysis was used to explore the risk factors of EDS and poor night-time sleep quality. Results Sleep disorders were common in PD patients. EDS was more prominent in men than in women. There was no significant difference in ESS scores between late-onset PD (LOPD) and early-onset PD. LOPD patients had a higher probability of poor night-time sleep quality. Male sex, disease duration, and depression were risk factors for EDS. In all patients of both sexes and all AAO, depression was a risk factor for poor night-time sleep. Conclusion More attention should be paid to sleep disorders of PD patients, especially male LOPD patients. Depression is a common risk factor for EDS and poor sleep quality in PD patients.
QKL was an effective and relatively safe option for the treatment of RSV-induced children pneumonia. These therapeutic effects were promising but need to be interpreted with caution due to variations in the treatment and methodological weakness in the studies.
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