Identification of fluid overload in elderly patients with chronic kidney disease using bioimpedance techniques.

Diagnosis of fluid overload (FO) in early stage is essential to manage fluid balance of patients with chronic kidney disease (CKD) and to prevent cardiovascular disease (CVD). However, the identification of fluid status in patients with CKD is largely dependent on the physician's clinical acumen. The ratio of fluid overload to extracellular volume (FO/ECV) has been used as a reference to assess fluid status.

Monitoring of Intraperitoneal Fluid Volume during Peritoneal Equilibration Testing using Segmental Bioimpedance.

Background: Ultrafiltration failure and fluid overload are common in peritoneal dialysis (PD) patients. Knowledge of intraperitoneal volume (IPV) and time to peak IPV during a dwell would permit improved PD prescription. This study aimed to utilize trunk segmental bioimpedance analysis (SBIA) to quasi-continuously monitor IPV (IPVSBIA) during the peritoneal dwell.

The effect of increased frequency of hemodialysis on vitamin C concentrations: an ancillary study of the randomized Frequent Hemodialysis Network (FHN) daily trial.

Background: Reports on vitamin C in HD patients have shown effects of vitamin C deficiency in association with scurvy symptoms. Dialyzability of water soluble vitamins is high, and substantial losses in those who are dialyzed more frequently were hypothesized. The randomized FHN Daily Trial compared the effects of in-center HD six versus three times per week.

Effect of Change in Fluid Status Evaluated by Bioimpedance Techniques on Body Composition in Hemodialysis Patients.

Objective: This prospective study uses calf bioimpedance spectroscopy (cBIS) to guide the attainment of dry weight (DW) in chronic hemodialysis (HD) patients. The primary aim of this study was to evaluate whether body composition is altered when fluid status is reduced to DW.

Methods: Target post-HD weight was gradually reduced from baseline (BL) until DW was achieved.

Effect of age and blood pressure on determination of normal fluid status in a general population using whole body and calf bioimpedance techniques.

Normal fluid status (dry weight) can be identified by hydration markers established in the healthy population. The general population average could be influenced by age with its accompanying physiological changes and/or illness. The aims of this study were (1) to evaluate the effect of age and systolic blood pressure (SBP) on these markers; (2) to compare mean values of hydration markers as assessed by different bioimpedance techniques.

A Randomized Crossover Trial of Dietary Sodium Restriction in Stage 3-4 CKD.

Background And Objectives: Patients with chronic kidney disease (CKD) are often volume expanded and hypertensive. Few controlled studies have assessed the effects of a sodium-restricted diet (SRD) in CKD.

Design, Setting, Participants, & Measurements: We conducted a randomized crossover trial to evaluate the effect of SRD (target <2 g sodium per day) versus usual diet on hydration status (by bioelectrical impedance spectroscopy) and blood pressure (BP) between May of 2009 and May of 2013.

Bioimpedance can solve problems of fluid overload.

Bioimpedance (BI) techniques for measuring normal hydration status (NHS) can be generally classified as (1) by frequency as single frequency at 50 kHz, BI analysis, and multifrequency BI spectroscopy and (2) by method as whole body (wrist to ankle) measurement and calf BI spectroscopy. The aim of this article was to review current BI methods for clinical practice in patients with end-stage of kidney disease. BI vector analysis using whole-body single-frequency BI at 50 kHz may be useful for population studies to indicate a range of degree of fluid loading and of nutritional status.

Agreement of single- and multi-frequency bioimpedance measurements in hemodialysis patients: an ancillary study of the Frequent Hemodialysis Network Daily Trial.

Background: Bioimpedance analysis (BIA) is well established to assess body composition. Agreements between single- and multi-frequency bioimpedance (SF-BIA, MF-BIS) measurements in subjects undergoing 6 or 3 times/week hemodialysis (HD) were analyzed.

Methods: Total body water (TBW) and intra- and extracellular fluid (ICF, ECF) of subjects enrolled in the Frequent Hemodialysis Network (FHN) Daily Trial (www.

Effect of change in fluid distribution in segments in hemodialysis patients at different ultrafiltration rates on accuracy of whole body bioimpedance measurement.

This study explored divergence (error) between ultrafiltration volumes (UFV) and intradialytic changes in extracellular volume (ΔECV) in hemodialysis (HD) patients measured by whole body (wBIS) and sum of segmental bioimpedance spectroscopy (sBIS). The primary aim of the study was to evaluate the effect of different ultrafiltration rates (UFR) on error of estimation of ΔECV by changes in their distribution in body segments (arm, trunk, and leg). Forty-four HD patients (26 men, age 63.

Comparison of bioimpedance techniques to detect changes in fluid status in hemodialysis patients.

Unlabelled: Bioimpedance (BI) is maturing as a clinical technique for assessing fluid volume status. The aim of this study was to compare the sensitivity of four BI methods to detect changes in fluid status in hemodialysis patients.

Methods: Forty-five patients were studied twice in the same week, i.

The association between arterial stiffness and fluid status in peritoneal dialysis patients.

Objectives: In this study our aim was to evaluate the relationship between degree of fluid status and arterial stiffness measured by pulse wave velocity (PWV) in peritoneal dialysis (PD) patients. Fluid status was determined by different methods including fluid overload measured by bioimpedance (Body Composition Monitor, BCM), calf normalized resistivity (CNR), plasma N-terminal fragment of B-type natriuretic peptide (NT-proBNP) and extracellular to intracellular water ratio (ECW/ICW).

Methods: Sixty PD patients were evaluated.

Early systolic blood pressure changes in incident hemodialysis patients are associated with mortality in the first year.

Background: In incident hemodialysis (HD) patients, the relationship between early systolic blood pressure (SBP) dynamics and mortality is unknown.

Methods: Baseline SBP levels were stratified into 5 categories ranging from <120 and ≥180 mm Hg. Early pre-HD SBP change was defined as the slope of pre-HD SBP from week 1 to 12 and categorized in quartiles (Q1, lowest slope).

[Daily protein intake 1,2--is that the panacea?].

Protein malnutrition is regarded as a risk factor of survival of hemodialysis patients. That's why good practice guidelines recommend a daily protein intake of 1.1 - 1.

The natural history of renal function following orthotopic heart transplant.

Background: The outcome of solid organ transplantation has dramatically improved after the introduction of the calcineurin inhibitor cyclosporine. With the increasing longevity of heart transplant recipients, the long-term effects of cyclosporine on renal function have become more evident. The natural history of kidney function following orthotopic heart transplant is not well defined and long-term follow up studies are scant.