AI Article Synopsis
- Bioimpedance analysis (BIA) enhances the assessment of nutritional and fluid status in dialysis patients, particularly in evaluating demographics and mortality over a 12-month period.
- In a study of 82 dialysis patients, older individuals showed increased extracellular water to total body water (ECW/TBW) and lower phase angle (PhA), both linked to higher mortality rates, especially in those aged 65 and older.
- Findings suggest that BIA can effectively inform clinical decisions regarding patient care and management, as specific BIA measures are associated with one-year survival outcomes in this population.
Article Abstract
Background: Bioimpedance analysis (BIA) has been demonstrated to add accuracy to nutritional and volume status assessments in dialysis (HD) patients.
Aim: to describe a sample of dialysis patients from a single center on their demographics and BIA of volume distribution and nutritional status, and mortality during 12-month follow-up.
Methods: prospective observational cohort study to evaluate vintage HD patients with single-frequency BIA.
Results: we evaluated 82 patients, 29% over 65 years old. Elderly patients had higher ECW/TBW (0.51 vs. 0.44, p < 0.0001), and narrower phase angle (PhA) (4.9 vs. 6.4º, p < 0.0001). Fifteen patients (18.2%) died during follow-up, eight (53%) were elderly. Death was associated with age (62.6 vs. 50.2 years, p = 0.012), post-HD PhA (4.8 vs. 6.2º, p = 0.0001), and post-HD ECW/TBW (0.50 vs. 0.45, p = 0.015). The ROC curve analysis to predict mortality found ECW/TBW ≥ 0.47 and PhA ≤ 5.5º to have the best sensitivity and specificity. One-year patient survival was lower with post-HD ECW/TBW ≥ 0.47 (69.5% vs. 90.6%, p = 0.019), age ≥ 65 years (64.2%, vs. 86.2%, p = 0.029), and PhA ≤ 5.5º (68.2 vs. 91.0%, p = 0.002). Cox regression analysis demonstrated that PhA [HR 5.04 (95%CI 1.60-15.86), p = 0.006] remained associated with death after adjusting for age and ECW/TBW.
Conclusion: BIA is useful in assessing volume distribution and nutrition in HD patients, and combined with clinical judgement, may help determine dry weight, especially in elderly patients. Narrower PhA and higher ECW/TBW after HD were associated with poorer one-year survival.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10697165 | PMC |
| http://dx.doi.org/10.1590/2175-8239-JBN-2022-0037en | DOI Listing |
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