Application of DSM-BIA in dry weight assessment in continuous ambulatory peritoneal dialysis

Author(s):  
Qi Chen ◽  
Zheng Wang ◽  
Na Liu ◽  
Shujuan Mu ◽  
Peng Guo ◽  
...  

Abstract ObjectivesDry weight assessment (DWA) is an important part of dialysis and fluid management in patients receiving renal replacement therapy. With the development of bioimpedance analysis (BIA), the development of the direct segmental multi-frequency BIA (DSM-BIA) has provided a more convenient measure for DWA of dialysis patients, but its accuracy remains unclear. This study was designed to evaluate the application of DSM-BIA in DWA of continuous ambulatory peritoneal dialysis (CAPD) patients.DesignThis is a cross-sectional study. Using the conventional BIA as a reference, we examined the accuracy of the DSM-BIA technique for assessing dry weight in CAPD patients and analyzed the potential factors influencing their fluid volume status.Setting and Participants:A total of 31 patients with end-stage renal disease receiving CAPD and 310 healthy volunteers were recruited for this study.MethodsThe intraclass correlation coefficients (ICC) and Bland-Altman plots were used to assess the consistency between DSM-BIA and the conventional BIA for DWA. Univariate and multivariate linear regression analyses were used to explore the influencing factors associated with the edema index.ResultsDSM-BIA and the conventional BIA technology were consistent in DWA in CAPD patients (ICC female 0.972, ICC male 0.882, ICC total 0.960). Similarly, Bland-Altman plots showed good agreements between the two methods in DWA for both genders. Univariate and multivariate linear regression analysis showed both eGFR level (P = 0.04) and serum NT-pro BNP concentration (P = 0.007) were positively correlated with the ratio of extracellular water to total body water (ECW/TCW).ConclusionsDSM-BIA in DWA has good accuracy in clinical applications and has potential application value for fluid volume management in CAPD patients.

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S675-S675
Author(s):  
Jason C Gallagher ◽  
Sara Lee ◽  
Leah Rodriguez ◽  
Jacqueline Emily Von Bulow ◽  
Kaede Ota Sullivan

Abstract Background Respiratory viral panels (RVPs) can detect multiple viral pathogens and give clinicians diagnostic confidence to discontinue antibiotics. However, relatively little is known about how these tests influence antibiotic prescribing in hospital settings. Methods This was a 26-month retrospective chart review of patients with positive RVPs. Hospitalized adults receiving antibiotics at the time of the RVP were included. Exclusion criteria were: ICU care, solid-organ transplantation (SOT), positive RVP for influenza, positive bacterial cultures, and antibiotic administration for bacterial infection (e.g., cellulitis). A multivariate linear regression model was created to investigate associations with longer antibiotic use after a positive RVP. Results 1,346 patients were screened and 242 met inclusion criteria. Primary reasons for exclusion were SOT, ICU, and influenza diagnosis. Patients were a median age of 60.5 years [IQR 51,70] and 35.5% were men. The median length of stay (LOS) was 4 days [IQR 3.6]. 233 patients (6.3%) had chest radiology performed, of which 71 (30.4%) had possible pneumonia noted. 50 (20.7%) were immunocompromised (IC). 199 (82.2%) had a history of pulmonary disease, most commonly COPD. Rhinovirus was isolated in 156 patients (64.5%), followed by metapneumovirus (35, 14.9%) and RSV (32, 13.3%). Antibiotics were given for a median total of 3 days [IQR 3.6]; they were discontinued within 24 hours of the RVP result in 107 patients (44.2%). Conclusion In this population of patients with viral infection and no discernable bacterial infection, 44.2% of patients had antibiotics discontinued within 24 hours of RVP results. On multivariate linear regression analysis, younger age, longer LOS, and IC status were associated with longer antibiotic duration after a positive RVP. A comparison with patients with negative RVP results could reveal if the test prompted discontinuation. Disclosures All authors: No reported disclosures.


Author(s):  
Elżbieta Kimak ◽  
Andrzej Książek ◽  
Janusz Solski

AbstractStudies were carried out in 183 non-dialyzed, 123 hemodialysis, 81 continuous ambulatory peritoneal dialysis and 35 post-transplant patients and in 103 healthy subjects as a reference group. Lipids and apolipoprotein (apo)AI and apoB were determined using Roche kits. An anti-apoB antibody was used to separate apoB-containing apoCIII and apoE-triglyceride-rich lipoprotein (TRL) in the non-high-density lipoprotein (non-HDL) fraction from apoCIIInonB and apoEnonB in the HDL fraction in four groups of patients with chronic renal failure (CRF) and healthy subjects. Multivariate linear regression analysis was used to investigate the relationship between triglyceride (TG) or HDL-cholesterol (HDL-C) concentrations and lipoproteins. Dyslipidemia varied according to the degree of renal insufficiency, the type of dialysis and therapy regime in CRF patients. Lipoprotein disturbances were manifested by increased TG, non-HDL-C and TRL concentrations, and decreased HDL-C and apoAI concentrations, whereas post-renal transplant patients showed normalization of lipid and lipoprotein profiles, except for TG levels and total apoCIII and apoCIIInonB. The present study indicates that CRF patients have disturbed lipoprotein composition, and that hypertriglyceridemia and low HDL-C concentrations in these patients are multifactorial, being secondary to disturbed lipoproteins. The method using anti-apoB antibodies to separate apoB-containing lipoproteins in the non-HDL fraction from non-apoB-containing lipoproteins in HDL can be used in the diagnosis and treatment of patients with progression of renal failure or atherosclerosis. The variability of TG and HDL-C concentrations depends on the variability of TRL and cholesterol-rich lipoprotein concentrations, but the decreases in TG and increases in HDL-C concentrations are caused by apoAI concentration variability. These relationships, however, need to be confirmed in further studies.


2021 ◽  
pp. 039156032110637
Author(s):  
Valerio Di Paola ◽  
Angelo Totaro ◽  
Giacomo Avesani ◽  
Benedetta Gui ◽  
Andrea Boni ◽  
...  

Purpose: Our aim was to explore the relation between FA and ADC, number and length of the periprostatic neurovascular fibers (PNF) by means of 1.5 T Diffusion Tensor Imaging (DTI) imaging through a multivariate linear regression analysis model. Methods: For this retrospective study, 56 patients (mean age 63.5 years), who underwent 1.5-T prostate MRI, including DTI, were enrolled between October 2014 and December 2018. Multivariate regression analysis was performed to evaluate the statistically significant correlation between FA values (dependent variable) and ADC, the number and the length of PNF (independent variables), if p-value <0.05. A value of 0.5 indicated poor agreement; 0.5–0.75, moderate agreement; 0.75–0.9, good agreement; 0.61–0.80, good agreement; and 0.9–1.00, excellent agreement. Results: The overall fit of the multivariate regression model was excellent, with R2 value of 0.9445 ( R2 adjusted 0.9412; p < 0.0001). Multivariate linear regression analysis showed a statistically significant correlation ( p < 0.05) for all the three independent variables. The r partial value was −0.9612 for ADC values ( p < 0.0001), suggesting a strong negative correlation, 0.4317 for the number of fiber tracts ( p < 0.001), suggesting a moderate positive correlation, and −0.306 for the length of the fiber tracts ( p < 0.05), suggesting a weak negative correlation. Conclusions: Our multivariate linear regression model has demonstrated a statistically significant correlation between FA values of PNF with other DTI parameters, in particular with ADC.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Chisa Matsumoto ◽  
Susanne Rautiainen ◽  
Elise Roche ◽  
JoAnn E Manson ◽  
Howard D Sesso

Introduction: A multivitamin (MV) is the most commonly taken supplement in older U.S. adults. Arterial stiffness is an important intermediate marker of cardiovascular disease (CVD). However, few studies have examined the association of MV use and arterial stiffness. Hypothesis: Regular multivitamin use is associated with lower levels of arterial stiffness. Methods: A subcohort of participants enrolled in the COcoa Supplement and Multivitamin Outcomes Study (COSMOS), a large scale randomized clinical trial testing a MV and a cocoa extract supplement on CVD and cancer, completed baseline measurement of arterial stiffness assessed by pulse wave velocity (PWV), augmentation index (AI), and central blood pressure (CBP). Frequency and duration of MV use was assessed via self-report questionnaire at baseline. The cross-sectional association of MV use and arterial stiffness was evaluated by multivariate linear regression with adjustment for conventional CVD risk factors. We also performed subgroup analyses to evaluate effect modification between MV use and sex, age, body mass index (BMI), and hypertension. Results: A total of 470 (229 women and 241 men) COSMOS participants were included in this study, with mean age 69.1±5.2 years, of whom 150 (32%) reported current MV use at baseline. Multivariate linear regression analysis revealed that current MV use (yes versus no) was significantly associated with lower PWV (β:-0.59±1.02, p=0.004) but not associated with other measures of arterial stiffness, including AI or CBP. There were also no consistent associations between frequency and duration of MV use with any of the measures of arterial stiffness. Also, there was no effect modification by sex, age, BMI, or hypertension on the association between MV use and arterial stiffness. Conclusions: MV use was associated with lower PWV in older subjects. Further results from the COSMOS trial on randomized MV supplementation and changes in arterial stiffness over 2 years will further elucidate the effects of MV on arterial stiffness.


2020 ◽  
Vol 45 (3) ◽  
pp. 442-454 ◽  
Author(s):  
Sang Hyuk Kim ◽  
Hyang Ki Min ◽  
Sung Woo Lee

Introduction: Thyroid function is evaluated by thyroid stimulating hormone (TSH) and free thyroxine (fT4). Although many studies have indicated an intimate relationship between thyroid hormones and kidney functions, reports about the simultaneous evaluation of TSH and fT4 are rare. Objective: We aimed to analyze the association between TSH and kidney function, with emphasis on a potential nonlinear relationship, and identify an independent relationship between fT4 and kidney function. Methods: We reviewed the data of 7,061 subjects in the Korea National Health and Nutrition Examination Surveys who were randomly subsampled for thyroid function evaluation between 2013 and 2015. A total of 5,578 subjects were included in the final analysis, after excluding people <18 years old, and those with a short fasting time, abnormal fT4 levels, and thyroid disease or related medications. Creatinine-based estimated glomerular filtration rate (eGFR) was used to define kidney function. Results: A 1 mmol/L increase of logarithmic TSH was associated with decreased eGFR (β: –1.8; 95% CI –2.3 to –1.2; p < 0.001), according to multivariate linear regression analysis. On the multivariate generalized additive model plot, TSH demonstrated an L-shaped relationship with eGFR, showing a steeper slope for 0–4 mIU/L of TSH. A 1 µg/dL increase of fT4 was also associated with decreased eGFR (β: –7.0; 95% CI –0.94 to –4.7; p < 0.001) on the multivariate linear regression analysis; this association was reversed after adjusting for age. On the mediation analysis, the indirect effect via age and direct effect per 1 µg/dL increase of fT4 on eGFR was 9.9 (8.1 to 11.7, p < 0.001) and –7.1 (–9.3 to –4.8, p < 0.001), respectively. Conclusions: Increased TSH was associated with decreased eGFR, particularly in the reference range. The direct effect of increased fT4 was decreased eGFR, which may be affected indirectly by age.


2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Lingli Zhou ◽  
Xiaoling Cai ◽  
Yingying Luo ◽  
Fang Zhang ◽  
Linong Ji

Identifying factors that may impact vildagliptin’s efficacy could contribute to individualized treatment for patients with type 2 diabetes. In the current study, we aimed to assess the correlation between patient baseline triglyceride (TG) and efficacy of vildagliptin in Chinese patients with type 2 diabetes in a post hoc analysis of the VISION study. TG-based subgroup analysis was performed to evaluate baseline TG’s impact on the decrease of glycated hemoglobin (HbA1c) in patients receiving vildagliptin plus low-dose metformin (VLDM) vs. high-dose metformin (HDM). Additionally, multivariate linear regression was performed to assess the association between baseline TG and HbA1c reduction at weeks 12 and 24 for patients receiving VLDM vs. HDM. For patients receiving VLDM, baseline TG≤2.03 mmol/L was associated with significantly greater HbA1c reduction vs. TG>2.03 mmol/L at week 12, but not at week 24. Additionally, multivariate linear regression analysis revealed a significant independent association and an association short of statistical significance between patient baseline TG and the HbA1c-reducing efficacy of VLDM at weeks 12 (P<0.001) and 24 (P=0.082), respectively, while such association was absent for HDM. Collectively, baseline TG was an independent predictive factor for the efficacy of a dipeptidyl peptidase-IV in treating type 2 diabetes during its initial use.


2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
João N. Beato ◽  
João Esteves-Leandro ◽  
David Reis ◽  
Manuel Falcão ◽  
Vítor Rosas ◽  
...  

Purpose. To analyze and compare corneal structural and biomechanical properties, characterized by corneal hysteresis (CH) and resistance factor (CRF), between patients with and without type 2 diabetes mellitus (DM), and determine the main ocular variables that influence them. Methods. Sixty diabetic and 48 age- and sex-matched non-DM patients were enrolled in this cross-sectional study. The DM group was analyzed according to DM duration (<or ≥ 10 years), HbA1c levels (<or ≥ 7%), and presence of retinopathy. CH and CRF were evaluated using the Ocular Response Analyzer® (ORA). Central corneal thickness (CCT) was determined by Scheimpflug tomography (Pentacam® HR). Intraocular pressure was obtained with ORA (IOPcc) and Goldmann applanation tonometry (IOP-GAT). Univariate and multivariate linear regression analyses were performed to evaluate the relationship between demographical, clinical, and ocular variables with the biomechanical properties. Results. There were no statistically significant differences in the CH and the CRF between DM and non-DM groups (p=0.637 and p=0.439, respectively). Also, there was no statistical difference between groups for the CCT, IOPcc, or IOP-GAT. Multivariate linear regression analysis showed that CH was positively associated with CCT (p<0.001) and negatively associated with IOPcc (p<0.001), while CRF was positively associated with CCT (p<0.001) and IOPcc (p=0.014). Conclusion. The CCT and IOPcc were found to be the main parameters that affect corneal biomechanical properties both in diabetics and controls. In this study, there was no significant effect of DM type 2 on corneal biomechanics.


1986 ◽  
Vol 32 (7) ◽  
pp. 1279-1284 ◽  
Author(s):  
J Valsamis ◽  
J Van Peborgh ◽  
H Brauman

Abstract We evaluated the relative contribution to the diagnosis of hyperparathyroid disease from current laboratory indices of parathyroid function--plasma calcium (I), phosphate (II), carboxy-terminal (III) and predominantly amino-terminal (IV) radioimmunoassays of parathyrin, the urinary excretion ratios of cyclic adenosine monophosphate (cAMP) to creatinine (V) or to glomerular filtrate (VI), and the ratio of the nephrogenous fraction of cAMP to glomerular filtrate (VII)--in 224 subjects: 40 with surgically proven hyperparathyroid disease, the others normoparathyroid. The decreasing order of sensitivity was I greater than VI greater than VII greater than V greater than III greater than IV greater than II; all these indices differed significantly between normoparathyroid and hyperparathyroid patients. The decreasing order of specificity was VII, III greater than I greater than IV greater than V, II greater than VI. Discriminant multivariate linear regression analysis was performed in a subset of 58 subjects (17 hyper- and 41 normoparathyroid) from the population studied here, chosen because all of the laboratory indices were determined for each subject. The classification accuracy was 98.3% for combining I, VII, and III (r = 0.908), or I and V (r = 0.893), or I and VII (r = 0.889). The other variables did not add to the precision of classification.


2020 ◽  
Vol 10 (4) ◽  
pp. 239-249
Author(s):  
Abbas Ghafouri ◽  
◽  
Fariba Mohammadi ◽  
Behnaz Ganji ◽  
◽  
...  

Purpose: Several tests have been proposed as injury predictor inventories in various sports; however, it is important to recognize which test is more appropriate to predict the injuries of a particular sport. Therefore, the present study aimed to investigate the relationship between selected functional tests and lower limb injuries in elite male wushu athletes. Methods: In total, 40 wushu player were recruited from the national league (Mean±SD age: 25.1±4.9 y, weight: 67.3±7.7 kg, height: 175.3±4.7 cm). Functional Movement Screening (FMS), Tuck jump, single and double leg squats, Star Excursion Balance Test (SEBT), and Stork balance tests were performed in this research. All of the study variables were measured before the national competition, and after the competition, the rate of the injuries were assessed. The correlation between them was evaluated, subsequently. Descriptive data were used to describe the collected results. Besides, multivariate linear regression analysis was used to explore the relationship between the study variables. Results: Multivariate linear regression analysis data suggested that LESS, stroke balance test, single-leg squat, and SEBT failed to predict lower extremities injuries; however, Tuck jump, FMS, and double leg squat could predict lower extremities injuries. Conclusion: Based on the collected results, among the studied tests, trainers and researchers are suggested to employ the Tuck jump, FMS, and double leg squat tests to predict injuries in wushu male players; this test can also be used to prevent injuries in players.


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