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Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Ribitsch, W; Stockinger, J; Schneditz, D.
Bioimpedance-based volume at clinical target weight is contracted in hemodialysis patients with a high body mass index.
Clin Nephrol. 2012; 77(5):376-382
Doi: 10.5414/CN107078
Web of Science
PubMed
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- Leading authors Med Uni Graz
- Ribitsch Werner
- Schneditz Daniel
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- Abstract:
- Objective: To compare volume overload in stable hemodialysis (HD) patients assessed by standard clinical judgment with data obtained from bioimpedance analysis. Methods: Ultrafiltration volume (Vu) was delivered as prescribed by standard clinical practice. Independently, a measure for volume overload was assessed by a clinical score (S-W). The Body Composition Monitor (BCM, Fresenius Medical Care, Bad Homburg, Germany) was used to derive values for extracellular volume (Vs) and volume overload (V-O) before HD. Arterial pressures (P-0, P-1) and serum levels of NT-pro-BNP (B-0, B-1) were evaluated before and after HD. Results: In 28 patients (11 women, age: 51.3 +/- 13.3 y, body mass index (BMI) 18.5 - 40.9 kg/m(2); V-E: 17.91 +/- 3.45 1) delivered V-U was 2.41 +/- 1.03 1 and not different from V-O of 2.08 +/- 1.49 1 derived from bioimpedance analysis. There was no correlation between V-O and V-U (r = -0.15, p = 0.46) but a negative correlation between the difference V-O - V-U (i.e., the volume overload at treatment end) and BMI (r = -0.49, p ANDlt; 0.01). Positive correlations were observed between B-0 and the relative volume overload (= V-O/V-E) (r = 0.58, p ANDlt; 0.001). Conclusion: The well recognized relationship between cardiac natriuretic peptides and volume expansion was confirmed. The volume overload at treatment end (V-O-V-U) was negligible for the whole group of patients but more negative with increasing BMI. It therefore appears that in comparison to bioimpedance-based evaluation the clinical judgment overestimates volume overload in obese patients which leads to the delivery of high ultrafiltration volumes and to volume contraction at the end of a dialysis session in this group of patients.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Adult -
- Biological Markers - blood
- Blood Pressure -
- Blood Volume -
- Body Composition -
- Body Mass Index -
- Chi-Square Distribution -
- Electric Impedance -
- Extracellular Fluid - metabolism
- Female -
- Humans -
- Kidney Diseases - blood
- Male -
- Middle Aged -
- Models, Biological -
- Natriuretic Peptide, Brain - blood
- Obesity - blood
- Peptide Fragments - blood
- Renal Dialysis - adverse effects
- Treatment Outcome -
- Find related publications in this database (Keywords)
- bioimpedance
- body mass index
- natriuretic peptide
- ultrafiltration