대한신장학회

논문분류	춘계학술대회 초록집
제목	The Association between Ambulatory Blood Pressure Patterns and Body Fluid Volume in Patients with Chronic Kidney Disease
저자	Youn kyung KEE1, Min-uk CHA1, Misol LEE1, Ki heon NAM1, Seong yeong AN1, Hyoungnae KIM1, Seohyun PARK1, Hae-ryong YUN1, Jong hyun JHEE1, Jung tak PARK1, Seung hyeok HAN1, Hyeon chang KIM2, Sungha PARK3, Shin-wook KANG1,4, *Tae-hyun YOO1
출판정보	2017; 2017(1):
키워드	Ambulatory blood pressure monitoring, cardiovascular disease, chronic kidney disease, volume overload
초록	Objectives : Abnormal dipping patterns of ambulatory blood pressure monitoring (ABPM) and excessive body fluid volume are frequently observed and both of them are significant risk factors for cardiovascular diseases in chronic kidney disease (CKD) patients. With lacking evidences of a link between volume overload and ABPM patterns in CKD patients, present study is aimed to elucidate the cardiovascular risk according to ABPM patterns and body fluid volume status in CKD patients. Methods : Patients with CKD were prospectively enrolled by Cardiovascular and Metabolic Disease Etiology Research center (CMERC) of Yonsei University College of Medicine between November 2013 and December 2016. 24hour ABPM was performed and body fluid volume was assessed by the bioelectrical impedance analysis. And the ratio of extracellular water (ECW) to total body water (TBW) was calculated. Patients were divided into normohydrated (ECW/TBW < 0.389) and overhydrated state (ECW/TBW >0.390). Coronary calcium score and carotid-femoral pulse wave velocity (cfPWV) were also evaluated in study subjects. Results : The mean age of the subjects was 60.4 years and 873 (54.3%) were men. Among the total of 1608 patients, 1132 (70.4%) patients were in normohydrated state and 476 (29.6%) patients were overhydrated. Overhydrated patients had older age, higher proportion of female, and had more comorbid diseases. Based on monitoring of office BP and ABPM, most of parameters for blood pressure (BP) in overhydrated group were significantly higher compared to those in normohydrated group. The proportion of pathologic dipping pattern like non-dipper or reverse-dipper in overhydrated group was significantly higher compared to normohydrated group. In addition, body fluid volume overload was significantly associated with CCS and cfPWV. Multivariate logistic regression indicated that non-dipping patterns with overhydration was independently associated with increased CCS (OR, 2.504; 95% CI, 1.554-4.035; P < 0.001) and cfPWV (OR, 1.810; 95% CI, 1.061-1.105; P < 0.001). Conclusions : Body fluid volume overload was associated with high BP and abnormal ABPM dipping patterns in CKD patients. In addition, abnormal dipping patterns combined with fluid overload were associated with increased cardiovascular risk in CKD patients.
원문(PDF)	PDF 원문보기

간행물 검색

대한신장학회 회원관리 규정