scholarly journals Comparison of anthropometric equations for estimation of total body water in peritoneal dialysis patients

2003 ◽  
Vol 18 (2) ◽  
pp. 384-389 ◽  
Author(s):  
G. Woodrow
Keyword(s):  
Peritoneal Dialysis ◽  
Total Body Water ◽  
Body Water ◽  
Dialysis Patients ◽  
Total Body

The Ratio of Extracellular Fluid to Total Body Water and Technique Survival in Peritoneal Dialysis Patients

2004 ◽  
Vol 24 (4) ◽  
pp. 353-358 ◽  
Author(s):  
Colin H. Jones ◽  
Charles G. Newstead
Keyword(s):  
Peritoneal Dialysis ◽  
Total Body Water ◽  
Extracellular Fluid ◽  
Residual Renal Function ◽  
Body Water ◽  
C Reactive Protein ◽  
Dialysis Patients ◽  
Technique Survival ◽  
Reactive Protein ◽  
Total Body

Background Patients receiving peritoneal dialysis experience a high technique failure rate and are often overhydrated. We examined whether an increased extracellular fluid volume (VECF) as a proportion of the total body water (VTBW) predicted technique survival (TS) in a prevalent patient cohort. Methods The VECF and VTBW were estimated by multiple-frequency bioelectric impedance in 59 prevalent peritoneal dialysis patients (median time on dialysis 14 months). Demographic, biochemical (albumin, C-reactive protein, and ferritin), and anthropometric data, forearm muscle strength, nutritional score by three-point Subjective Global Assessment, residual renal function, dialysate-to-plasma (D/P) creatinine ratio, total weekly Kt/V urea, total creatinine clearance, normalized protein equivalent of nitrogen appearance, and midarm muscle circumference were also assessed. Technique survival was determined at 3 years, and significant predictors of TS were sought. Results In patient groups defined by falling above or below the median value for each parameter, only residual renal function ( p = 0.002), 24-hour ultrafiltrate volume ( p = 0.02), and VECF / VTBW ratio ( p = 0.05) were significant predictors of TS. Subjects with a higher than median VECF / VTBW ratio had a 3-year TS of 46%, compared to 78% in subjects with a lower than median value. In multivariate analysis, systolic blood pressure and VECF / VTBW ratio (both p < 0.05) were significant predictors of TS. C-reactive protein approached significance. Conclusion Increased ratio of extracellular fluid volume to total body water is associated with decreased TS in peritoneal dialysis.

scholarly journals Measuring total body water in peritoneal dialysis patients using an ethanol dilution technique

1999 ◽  
Vol 56 (6) ◽  
pp. 2297-2303 ◽  
Author(s):  
Naomi V. Dahl ◽  
Edward F. Foote ◽  
Toros Kapoian ◽  
Caroline A. Steward ◽  
Richard A. Sherman
Keyword(s):  
Peritoneal Dialysis ◽  
Total Body Water ◽  
Body Water ◽  
Dialysis Patients ◽  
Dilution Technique ◽  
Total Body

scholarly journals Total body water and body composition in chronic peritoneal dialysis patients.

1997 ◽  
Vol 8 (12) ◽  
pp. 1906-1914 ◽  
Author(s):  
W Arkouche ◽  
D Fouque ◽  
C Pachiaudi ◽  
S Normand ◽  
M Laville ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Total Body Water ◽  
Resting Metabolic Rate ◽  
Bioelectrical Impedance ◽  
Skinfold Thickness ◽  
Body Water ◽  
Fat Free Mass ◽  
Chronic Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Total Body

In this investigation, total body water (TBW) in ten chronic peritoneal dialysis patients was studied by deuterium (TBW-2H), skinfold thickness (TBW-ST), Watson formula (TBW-WA), 58% of body weight (TBW-58%), and bioelectrical impedance (TBW-BIA), and these results were compared with the reference oxygen18 (TBW-18O) method. We also analyzed the fat-free mass (FFM) by skinfold thickness (FFM-ST), bioelectrical impedance (FFM-BIA), oxygen18 (FFM-18O), and creatinine kinetics method (FFM-CK). In addition, resting metabolic rate was measured by indirect calorimetry. Compared with TBW-18O, TBW-58% and TBW-BIA were significantly different (P < 0.01). TBW-2H overestimated TBW-18O by 4.3%. TBW-ST and TBW-WA gave slightly greater values than TBW-18O, although these values were nonstatistically significant. The best prediction of total body water from these methods was obtained with the Watson formula. When Kt/V was calculated from these results, the values obtained were statistically greater (BIA, P < 0.001) and smaller (58% BW, P < 0.01) than those obtained with either 18O or Watson formula. The fat-free mass estimation also led to discrepant findings. Indeed, FFM-CK was significantly lower (P < 0.05) as compared with FFM-ST, FFM-BIA, or FFM-18O. Resting metabolic rate was strongly correlated with FFM estimated by skinfold thickness (r = 0.91, P < 0.001), bioelectrical impedance (r = 0.85, P < 0.005), and 18O (r = 0.77, P < 0.01), but not when fat-free mass was estimated by the creatinine kinetic method. The water content of fat-free mass estimated by skinfold thickness was found to be 69.7 +/- 6.9% in these patients, a value lower than the standard 73.2% found in healthy adults. This study confirms that there is an abnormal water distribution in chronic peritoneal dialysis patients. However, when compared with the oxygen18 reference method, the Watson formula allows a reliable estimation of Kt/V.

scholarly journals Body Sodium, Potassium and Water in Peritoneal Dialysis-Associated Hyponatremia

2014 ◽  
Vol 34 (3) ◽  
pp. 253-259 ◽  
Author(s):  
Yijuan Sun ◽  
David Mills ◽  
Todd S. Ing ◽  
Joseph I. Shapiro ◽  
Antonios H. Tzamaloukas
Keyword(s):  
Peritoneal Dialysis ◽  
Clinical Evaluation ◽  
Serum Sodium ◽  
Total Body Water ◽  
Sodium Concentration ◽  
Body Water ◽  
Serum Sodium Concentration ◽  
Monovalent Cations ◽  
Body Sodium ◽  
Total Body

Objective This report presents a method quantitatively analyzing abnormalities of body water and monovalent cations (sodium plus potassium) in patients on peritoneal dialysis (PD) with true hyponatremia. Methods It is well known that in the face of euglycemia serum sodium concentration is determined by the ratio between the sum of total body sodium plus total body potassium on the one hand and total body water on the other. We developed balance equations that enabled us to calculate excesses or deficits, relative to the state of eunatremia and dry weight, in terms of volumes of water and volumes of isotonic solutions of sodium plus potassium when patients presented with hyponatremia. We applied this method retrospectively to 5 episodes of PD-associated hyponatremia (serum sodium concentration 121–130 mEq/L) and compared the findings of the method with those of the clinical evaluation of these episodes. Results Estimates of the new method and findings of the clinical evaluation were in agreement in 4 of the 5 episodes, representing euvolemic hyponatremia (normal total body sodium plus potassium along with water excess) in 1 patient, hypovolemic hyponatremia (deficit of total body sodium plus potassium along with deficit of total body water) in 2 patients, and hypervolemic hyponatremia (excess of total body sodium along with larger excess of total body water) in 1 patient. In the 5th patient, in whom the new method suggested the presence of water excess and a relatively small deficit of monovalent cations, the clinical evaluation had failed to detect the cation deficit. Conclusions Evaluation of imbalances in body water and monovalent cations in PD-associated hyponatremia by the method presented in this report agrees with the clinical evaluation in most instances and could be used as a guide to the treatment of hyponatremia. Prospective studies are needed to test the potential clinical applications of this method.

scholarly journals Hypervolemia screening in predialysis healthcare for hemodialysis patients using fuzzy color reason analysis

2017 ◽  
Vol 13 (1) ◽  
pp. 155014771668509 ◽  
Author(s):  
Wei-Ling Chen ◽  
Chung-Dann Kan ◽  
Chia-Hung Lin ◽  
Ying-Shin Chen ◽  
Yi-Chen Mai
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Total Body Water ◽  
Dry Weight ◽  
Body Water ◽  
Fluid Volume ◽  
Area Network ◽  
Dialysis Patients ◽  
Blood Pressures ◽  
Total Body

Maintaining adequate dry weight and fluid volume balance is an important issue for dialysis patients. Malnutrition and sodium intake are the primary factors that cause fluid volume imbalance and changes in body weights. Inadequate dry weight control results in higher levels of blood pressures and is related to various complications, such as volume overload, hypertension, congestive symptoms, and cardiovascular diseases. Moreover, inadequate fluid removal provokes hypotension during dialysis treatment. Thus, we propose an early warning tool based on fuzzy color reason analysis in predialysis healthcare for hypervolemia screening. The anthropometric method is a rapid, non-invasive, and simple technique for estimating the total body water. In this study, Watson standard formula is employed to estimate cross-sectional standard of total body water with the patient characteristics, including gender, age, height, and weight. In contrast to the experienced anthropometric formulas, Watson formula has less than 2% of margin errors and provides a criterion as a reference manner to estimate the total body water in patient’s normal dry weight. In addition, inadequate dry weight and total body water controls will lead to higher blood pressures. The systolic blood pressure is also an indicator to evaluate pre-hypertension of 120–139 mmHg and hypertension of greater than or equal to 140 mmHg. Therefore, the levels of two indicators, total body water and systolic blood pressure, are parameterized with fuzzy membership grades to describe the normal and the specific ranges of undervolemia and hypervolemia. A color reason analysis utilizes a hue–saturation–value color model to design a color perceptual manner for separating normal condition from hypervolemia or undervolemia. Normalized hue angle and saturation value provide a promising visual representation with color codes to realize the patients’ diagnosis. Dialysis patients with hypertension demonstrated that the proposed model can be used in clinical applications. In addition, a healthcare chair is carried out to measure blood pressure and weight in predialysis. The proposed assistant tool integrates an electronic pressure monitor and an electronic weight monitor, and fuzzy color reason analysis is also intended to be established in an intelligent vehicle via a WiFi wireless local area network for cloud computing.

Age-Related Extracellular to Total Body Water Volume Ratio (ECV/TBW) - Can it be Used for “Dry Weight” Determination in Dialysis Patients? Application of Multifrequency Bioimpedance Measurement

2002 ◽  
Vol 25 (8) ◽  
pp. 762-769 ◽  
Author(s):  
F. Lopot ◽  
B. Nejedlý ◽  
H. Novotná ◽  
M. Macková ◽  
S. Sulková
Keyword(s):  
Quantitative Determination ◽  
Total Body Water ◽  
Dialysis Patient ◽  
Dry Weight ◽  
Body Water ◽  
Dialysis Patients ◽  
Novel Method ◽  
Total Body ◽  
Bioimpedance Measurement

The article suggests a novel method for quantitative determination of optimal dry weight in dialysis patient based on their extracellular volume (ECV) to total body water (TBW) ratio and its relation to age. Values of ECV and TBW are evaluated by means of whole body multifrequency bioimpedometry. In an effort to find a suitable marker of hydration status in an individual from bioimpedance data, significant correlation has been found between ECV/TBW ratio and age in health. Assuming that all excess fluid in dialysis patients is stored exclusively in ECV and that distribution of their TBW at the state of optimal dry weight corresponds to that of a healthy person of the same age, the pre-dialysis ECV/TBW could be used for quantitative determination of optimal dry weight and/or of the ultrafiltration to reach this weight. Practical bioimpedance measurement of ECV/TBW in a group of dialysis patients both pre- and post-dialysis confirmed both above assumptions, i.e. nearly exclusively extracellular origin of ultrafiltration as well as normalisation of the ECV/TBW ratio towards the end of dialysis. Supporting evidence of increasing ECV/TBW value with age was also found in literature. Although the suggested method needs detailed analysis of possible disturbing factors (ethnic “specificity” of the reference ECV/TBW vs. age characteristics in health, possible difference in “biological” and “physical” age of dialysis patient and others), the article is published at this early stage to enable wider testing of the proposed novel method by different investigators.

Indirect Measures of Total Body Water May Confound Precise Assessment of Peritoneal Dialysis Adequacy

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 224-226 ◽  
Author(s):  
Rebecca Schmidt ◽  
Francis Dumler ◽  
Cosme Cruz
Keyword(s):  
Body Weight ◽  
Peritoneal Dialysis ◽  
Total Body Water ◽  
Electrical Conductance ◽  
Bioelectrical Impedance ◽  
Body Water ◽  
Dialysis Adequacy ◽  
Indirect Measures ◽  
Body Weights ◽  
Total Body

Urea kinetic modeling (UKM) has yet to be optimized as a practical tool for assessing adequacy of therapy In continuous ambulatory peritoneal dialysis (CAPO) patients. Watson equation (WV) and 58% body weight (58%WT) estimates of total body water (TBW) are Indirect measures likely to yield Imprecise estimates of Kt/V. Bioelectrical Impedance (BEl) measures body composition as a function of electrical conductance, minimizing fat contribution to TBW. TBW values were highest when measured as 58%WT and lowest when calculated from WV. These differences were most striking In patients with overweight body habitus. BEI-derived TBW correlated best with UKM values. The relationship between BEI-derived and anthropometrically derived TBW was best In patients of normal habitus. Kt/V values were highest when calculated from WV-derived volumes and significantly differed from Kt/V values calculated from BEI-derived and 58%WT volumes. When segregated by habitus, however, only In overweight patients was this pattern of clinical significance. Serial body weight, lean body mass, and TBW remained stable In patients of normal habitus. Overweight patients increased weight by 5%, lean mass by 2%, and TBW by 5%, 3%, and 2% when measured by 58%WT, WV, and BEl, respectively. BEl measures of TBW exclude fat mass and thus strengthen the use of Kt/V for assessing dialysis adequacy In CAPO patients of all body weights.

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