Assessment of fluid status in CAPD patients using the body composition monitor

Abstract Background and Aims Assessment of optimal hydration status in patients with end-stage renal disease (ESRD) on peritoneal dialysis (PD) is a challenge. Multiple diagnostic options to determine hydration status in PD patients are available. Multifrequency bioimpedance spectroscopy (MBIS) is a cheap, simple and non-invasive method of estimating body composition, including estimates of total body water (TBW), extracellular water (ECW), intracellular water (ICW) and the ratio between both spaces (ECW/ICW). Lung ultrasonography (LUS) and lung B-lines (lung comets) can be used for the evaluation of extravascular lung water. Ultrasound evaluation of inferior vena cava (UIVC) provides rapid, non-invasive assessment of a patient's hemodynamic and volume status. N-terminal pro-brain natriuretic peptide (NT-proBNP) is related to fluid status and fluid distribution. The aim of our study was to assess fluid status in PD patients comparing four different methods: MBIS, LUS, UIVC and NT-proBNP. Method We performed a single-centre cohort study in 19 PD patients. The body composition was measured using the portable whole-body MBIS device, Body Composition Monitor-BCM(®) (Fresenius Medical Care, Bad Homburg, Germany), LUS with portable US device (VScan, General Electrics Corporate), UIVC index with SonoSite US device. NT-proBNP was measured in a one-step sandwich chemiluminescent immunoassay (Dimension Vista® System 1500, Siemens Healthcare Diagnostics Inc., Newark, NJ, USA). Results The mean age of patients was 54 ± 10 years, mean dialysis vintage 53 (10-194) months, 63% were men. Thirteen (68.4%) patients had fluid overload (FO) > 1.1 L. Data of patients are presented in table 1. We found a statistically significant correlation between the number of lung comets and ECW/ICW ratio (r = 0.496, P = 0.031) and NT-proBNP (r = 0.759, P < 0.0001). In contrast, there was no significant correlation between the number of lung comets and UIVC (r = 0.221, P < 0.364). Conclusion According to our results, LUS with lung comets, MBIS with ECW/ICW ratio and NT-proBNP are useful and complementary methods for evaluation of fluid status in PD patients.

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Volume Control by Using the Body Composition Monitor in a Puerperal Patient on Hemodialysis

Electrolytes & Blood Pressure ◽

10.5049/ebp.2011.9.2.63 ◽

2011 ◽

Vol 9 (2) ◽

pp. 63

Author(s):

Wookyung Chung ◽

Shung Han Choi ◽

Jiyoon Sung ◽

Eul Sik Jung ◽

Dong Su Shin ◽

...

Keyword(s):

Body Composition ◽

The Body ◽

Volume Control ◽

Body Composition Monitor

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SP419USEFULNESS OF THE BODY COMPOSITION MONITOR IN SETTING DRY WEIGHT AT AN INITIATION OF HAEMODIALYSIS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfw170.26 ◽

2016 ◽

Vol 31 (suppl_1) ◽

pp. i231-i231

Author(s):

Shin Fukunaga ◽

Kazuhiro Yamada ◽

Akiko Baba ◽

Yuji Sato ◽

Shouichi Fujimoto

Keyword(s):

Body Composition ◽

Dry Weight ◽

The Body ◽

Body Composition Monitor

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Estimation of Body Composition and Normal Fluid Status Using a Calf Bioimpedance Technique

Blood Purification ◽

10.1159/000368937 ◽

2015 ◽

Vol 39 (1-3) ◽

pp. 25-31 ◽

Cited By ~ 9

Author(s):

Fansan Zhu ◽

Nathan W. Levin

Keyword(s):

Body Composition ◽

Gold Standard ◽

Dry Weight ◽

Practical Method ◽

The Body ◽

Normal Fluid ◽

Fluid Status ◽

Body Composition Study ◽

Highly Correlated ◽

A Prospective Study

The aims of this study in hemodialysis (HD) patients were: 1. To evaluate the relationship of calf bioimpedance with total body composition and fluid status as measured by gold standard methods. 2. To investigate the ability of calf normalized resistivity (CNR) to predict the normal fluid status (dry weight: DW) in a prospective study. In the body composition study (n = 41), fluid status (ECVBr/FFMMRI), muscle mass (MMMRI), and total adipose tissue (TATMRI) were measured by dilution (D2O and Br) and MRI methods three hours prior to HD treatment. Calf extracellular and intracellular resistance, resistivity, and CNR were measured with a multi-frequency bioimpedance device (Hydra 4200). In the fluid status study (n = 32 with 429 measurements), a nonlinear model based on the differences in CNR between patients and healthy subjects was established to predict DWcBIS previously determined by a separate continuous calf bioimpedance spectroscopy (cBIS) method. CNR significantly correlated with a gold standard hydration marker (ECVBr/FFMMRI). Calf body composition models were highly correlated with MMMRI (R2 = 0.85) and TATMRI (R2 = 0.85). DWcBIS prediction was validated with a CNR model in the degree of differences of 0.94 ± 0.18, 0.39 ± 0.7 and -0.02 ± 0.8 kg from DWcBIS when post HD fluid overload was 1.8 ± 1.2, 1.15 ± 0.8 and 0.54 ± 0.5 kg, respectively. These differences are not considered to be clinically significant. Conclusion: This practical method of calf bioimpedance is useful to predict body composition and normal fluid status in dialysis patients.

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Body composition monitoring in children and adolescents: reproducibility and reference values

European Journal of Pediatrics ◽

10.1007/s00431-021-03936-0 ◽

2021 ◽

Author(s):

Annelies Van Eyck ◽

Sofie Eerens ◽

Dominique Trouet ◽

Eline Lauwers ◽

Kristien Wouters ◽

...

Keyword(s):

Body Composition ◽

Reference Values ◽

Total Body Water ◽

The Body ◽

Lean Tissue ◽

Tissue Mass ◽

Lean Tissue Mass ◽

Body Composition Monitor ◽

Total Body

AbstractThere is an increasing need for suitable tools to evaluate body composition in paediatrics. The Body Composition Monitor (BCM) shows promise as a method, but reference values in children are lacking. Twenty children were included and measured twice by 4 different raters to asses inter- and intra-rater reproducibility of the BCM. Reliability was assessed using the Bland-Altman method and by calculating intraclass correlation coefficients (ICCs). The intra-rater ICCs were high (≥ 0.97) for all parameters measured by BCM as were the inter-rater ICCs for all parameters (≥ 0.98) except for overhydration (0.76). Consequently, a study was set up in which BCM measurements were performed in 2058 healthy children aged 3–18.5 years. The age- and gender-specific percentile values and reference curves for body composition (BMI, waist circumference, fat mass and lean tissue mass) and fluid status (extracellular and intracellular water and total body water) relative to age were produced using the GAMLSS method for growth curves.Conclusion: A high reproducibility of BCM measurements was found for fat mass, lean tissue mass, extracellular water and total body water. Reference values for these BCM parameters were calculated in over 2000 children and adolescents aged 3 to 18 years. What is Known• The 4-compartment model is regarded as the ‘gold standard’ of body composition methods, but is inappropriate for regular follow-up or screening of large groups, because of associated limitations. • Body Composition Monitor® is an inexpensive field method that has the potential to be an adequate monitoring tool.What is New• Good reproducibility of BCM measurements in children provides evidence to use the device in longitudinal follow-up, multicentre and comparative studies.• Paediatric reference values relative to age and sex for the various compartments of the body are provided.

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