通讯作者: 熊飞, xiongf23@sina.com

DOI：10.12201/bmr.202602.00066

Evaluation of Fluid Overload in Peritoneal Dialysis Patients Based on the Deviation of Actual Body Weight from Dry Weight

• 摘要：:目的:探讨基于生物电阻抗人体成分仪(body composition monitor,BCM)评估的干体重和实际测量体重计算的“实际体重相较于干体重的偏离度”(实际体重与干体重之差占干体重的百分比)在容量负荷中的应用价值。方法:对腹膜透析患者进行回顾性研究,收集患者基本特征、生化指标等数据,根据实际体重相较于干体重的偏离度进行分组,将过度水合体积(Over-hydration,OH)值作为诊断标准验证其有效性；探讨与实验室指标、透析充分性等指标之间的关系,分析其独立影响因素及容量负荷对患者心脑血管事件和生存的影响。结果:共纳入118例腹膜透析患者。以OH值为诊断标准,实际体重相较于干体重的偏离度在不同容量负荷状态中的分布呈梯度升高。ROC曲线判别容量超负荷的最佳截断值为2.015%(AUC=0.982)、严重容量超负荷的最佳截断值为4.165%(AUC=0.979)。偏离度与血清白蛋白、总Kt/V、残余肾功能、残余尿量呈负相关,与CCI评分、CRP、血压呈正相关(P<0.05)。男性、低血清白蛋白、患有糖尿病、高收缩压、残余尿量少是导致偏离度升高的独立危险因素(P<0.05)。实验B组生存率显著低于对照组和实验A组(P<0.05),发生心脑血管事件的风险显著高于对照组和实验A组(P<0.05)。结论:实际体重相较于干体重的偏离度是评估腹透患者容量负荷的可靠指标,基于高特异性、高阳性预测值及可操作性,建议2%和5%作为容量超负荷与严重容量超负荷的截断值。容量超负荷的患者心脑血管事件的发生率更高,生存率更低。

  关键词： :腹膜透析; 容量负荷; 干体重

   

  Abstract: : Objective: To evaluate the application value of the deviation of actual body weight from dry weight(calculated as the percentage difference between the patients actual weight and the BCM-assessed dry weight) in assessing volume status in peritoneal dialysis patients. Methods: A study of maintenance peritoneal dialysis patients was conducted. Patient basic characteristics and biochemical data were collected. Patients were grouped based on the deviation of their actual body weight from dry weight. The validity of using the Over-hydration (OH) value as a diagnostic criterion was verified. The study investigated the relationships between OH and laboratory parameters and dialysis adequacy, and analyzed the impact of volume load on the occurrence of cardiovascular/cerebrovascular events and patient survival. Results: A total of 118 maintenance peritoneal dialysis patients were included. Using the OH value as the diagnostic standard, the distribution of the deviation of actual weight from dry weight showed a gradient increase across different volume status groups. ROC curve analysis identified the optimal cut-off value for discriminating volume overload as 2.015%(AUC=0.982) and for severe volume overload as 4.165%(AUC=0.979). The deviation was negatively correlated with serum albumin, total Kt/V, residual renal function, and residual urine volume, positively correlated with CCI score, CRP, and blood pressure(P<0.05). Male, low serum albumin, diabetes, high systolic blood pressure, and low post-void residual urine volume are independent risk factors for increased deviation (P<0.05).The survival rate in experimental group B was significantly lower than that in the control group and experimental group A (P<0.05),and the risk of cardiovascular and cerebrovascular events was significantly higher than in the control group and experimental group A(P<0.05). Conclusion: Deviation of actual weight from dry weight is a reliable indicator for assessing volume load in peritoneal dialysis patients. Based on its high specificity, high positive predictive value, and feasibility, cutoff values of 2% and 5% can be used to distinguish volume overload and severe volume overload, respectively. This indicator is associated with parameters reflecting patients nutritional status, inflammatory levels, and dialysis adequacy. Volume overload significantly increases the risk of cardiovascular and cerebrovascular events and reduces survival rates.

  Key words: Peritoneal dialysis; volume load; dry body weight

  提交时间：2026-02-14

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
• html

• 图表

• 张叶, 杨莉. 美国腹膜透析激励政策的经验及对我国的启示. 2022. doi: 10.12201/bmr.202206.00011

  崔月颖. 基于熵权法的县域医共体健康绩效评价指标体系权重分析. 2024. doi: 10.12201/bmr.202405.00003

  和红, 张琳梓, 王攀, 闫辰聿, 王鑫. 青少年自我评价体重对心理健康的影响. 2022. doi: 10.12201/bmr.202207.00034

  凌钰, 沈艳萍. 腹膜转运功能与微炎症的研究进展. 2024. doi: 10.12201/bmr.202412.00066

  王耀羚, 杨畅, 高鑫, 李睿, 肖非易, 张晓路, 王培蒙, 顾雪非, 李雪, 郭武栋. 日本、韩国、新加坡健康体重管理政策的经验及启示——基于ICCC框架. 2025. doi: 10.12201/bmr.202508.00038

  β2-微球蛋白在腹膜透析中的研究进展 李珍妮. β2-微球蛋白在腹膜透析中的研究进展. 2025. doi: 10.12201/bmr.202507.00074

  吴杭, 邓雄伟. 早期负重功能锻炼对距腓前韧带断裂患者术后功能及满意度的影响. 2025. doi: 10.12201/bmr.202506.00053

  刘玉珠, 李洛华. 间皮细胞衰老与腹膜透析后腹膜纤维化的相关性研究进展. 2025. doi: 10.12201/bmr.202506.00031

  谢文佳, 倪佳宁, 周舒燕, 章婷婷, 蔡旭东. 中西结合慢性肾脏病管理对CKD3-5期非透析患者临床应用观察. 2024. doi: 10.12201/bmr.202409.00065

  彭紫怡, 毛阿燕. 基于层次分析法的我国公共卫生安全风险评估指标权重研究. 2025. doi: 10.12201/bmr.202503.00067

• 序号	提交日期	编号	操作
  1	2026-01-06	10.12201/bmr.202602.00066V1	下载

• 公开评论  匿名评论  仅发给作者 提交评论