scholarly journals Assessment of Hydration Status in Peritoneal Dialysis Patients: Validity, Prognostic Value, Strengths, and Limitations of Available Techniques

2020 ◽  
Vol 51 (8) ◽  
pp. 589-612 ◽  
Author(s):  
Maria-Eleni Alexandrou ◽  
Olga Balafa ◽  
Pantelis Sarafidis
Keyword(s):  
Peritoneal Dialysis ◽  
Natriuretic Peptide ◽  
Vena Cava ◽  
Volume Overload ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Preliminary Evidence ◽  
The Body ◽  
Volume Status ◽  
Hydration Status

Background: The majority of patients undergoing peritoneal dialysis (PD) suffer from volume overload and this overhydration is associated with increased mortality. Thus, optimal assessment of volume status in PD is an issue of paramount importance. Patient symptoms and physical signs are often unreliable indexes of true hydration status. Summary: Over the past decades, a quest for a valid, reproducible, and easily applicable technique to assess hydration status is taking place. Among existing techniques, inferior vena cava diameter measurements with echocardiography and natriuretic peptides such as brain natriuretic peptide and N-terminal pro-B-type natriuretic peptide were not extensively examined in PD populations; while having certain advantages, their interpretation are complicated by the underlying cardiac status and are not widely available. Bioelectrical impedance analysis (BIA) techniques are the most studied tool assessing volume overload in PD. Volume overload assessed with BIA has been associated with technique failure and increased mortality in observational studies, but the results of randomized trials on the value of BIA-based strategies to improve volume-related outcomes are contradictory. Lung ultrasound (US) is a recent technique with the ability to identify volume excess in the critical lung area. Preliminary evidence in PD showed that B-lines from lung US correlate with echocardiographic parameters but not with BIA measurements. This review presents the methods currently used to assess fluid status in PD patients and discusses existing data on their validity, applicability, limitations, and associations with intermediate and hard outcomes in this population. Key Message: No method has proved its value as an intervening tool affecting cardiovascular events, technique, and overall survival in PD patients. As BIA and lung US estimate fluid overload in different compartments of the body, they can be complementary tools for volume status assessment.

Volume Status in Peritoneal Dialysis

2011 ◽  
Vol 31 (2_suppl) ◽  
pp. 77-82 ◽  
Author(s):  
Graham Woodrow
Keyword(s):  
Peritoneal Dialysis ◽  
Fluid Management ◽  
Urine Volume ◽  
Good Control ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Volume Status ◽  
Promising Technique ◽  
Residual Urine Volume ◽  
Fluid Removal

Fluid homeostasis is one of the fundamental roles of the kidney and a crucial aspect in clinical management of patients on peritoneal dialysis (PD). Volume status has an important impact on the outcome of PD patients. Fluid excess leads to accelerated development of cardiovascular disease. Volume status may also impact on disorders and assessment of nutritional state. While ultrafiltration and residual urine volume have featured prominently in PD research, the importance of fluid intake and thirst in PD patients has received relatively little attention. Despite older studies suggesting that fluid overload is common in PD, current PD techniques can produce sufficient fluid removal to achieve good control of fluid, with associated cardiac benefits in PD patients. One of the major challenges is to apply these techniques to obtain ideal volume status in patients. Bioelectrical impedance analysis appears to be the most promising technique currently available to guide fluid management.

scholarly journals The efficacy of managing fluid overload in chronic peritoneal dialysis patients by a structured nurse-led intervention protocol

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Man Ching Law ◽  
◽  
Bonnie Ching-Ha Kwan ◽  
Janny Suk-Fun Fung ◽  
Kai Ming Chow ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Peritoneal Dialysis ◽  
Fluid Overload ◽  
Extracellular Volume ◽  
Volume Overload ◽  
Volume Status ◽  
Hydration Status ◽  
Dietary Control ◽  
Symptomatic Group ◽  
Intervention Protocol

Abstract Background Extracellular volume overload is a common problem in peritoneal dialysis (PD) patients and is associated with excessive mortality. We determine the effectiveness of treating PD patients with extracellular volume overload by a structured nurse-led intervention program. Methods The hydration status of PD patients was screened by bioimpedance spectroscopy (BIS). Fluid overload was defined as overhydration volume ≥ 2 L. Patients were classified into Symptomatic and Asymptomatic Groups and were managed by a structured nurse-led intervention protocol that focused on education and motivation. Hypertonic cycles were given for short term symptom relief for the Symptomatic group. Patients were followed for 12 weeks for the change in volume status, blood pressure, knowledge and adherence as determined by standard questionnaires. Results We recruited 103 patients (53 Symptomatic, 50 Asymptomatic Group. There was a significant reduction in overhydration volume 4 weeks after intervention, which was sustained by week 12; the overall reduction in overhydration volume was 0.96 ± 1.43 L at 4 weeks, and 1.06 ± 1.70 L at 12 weeks (p < 0.001 for both). The improvement was significant for both Symptomatic and Asymptomatic Groups. There was a concomitant reduction in systolic blood pressure in the Asymptomatic (146.9 ± 20.7 to 136.9 ± 19.5 mmHg, p = 0.037) but not Symptomatic group. The scores of knowledge, adherence to dietary control and advices on daily habit at week 4 were all significantly increased, and the improvement was sustained at week 12. Conclusions The structured nurse-led intervention protocol has a lasting benefit on the volume status of PD patients with extracellular volume overload. BIS screening allows prompt identification of volume overload in asymptomatic patients, and facilitates a focused effort on this high risk group.

scholarly journals Making the choice between bioelectrical impedance measures for body hydration status assessment

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Dmitry M. Davydov ◽  
Andrey Boev ◽  
Stas Gorbunov
Keyword(s):  
Body Schema ◽  
Bioelectrical Impedance ◽  
Information Criterion ◽  
The Body ◽  
Whole Body ◽  
Hydration Status ◽  
Status Assessment ◽  
Best Fitting ◽  
Body Compartments ◽  
Fitting In

AbstractSituational or persistent body fluid deficit (i.e., de- or hypo-hydration) is considered a significant health risk factor. Bioimpedance analysis (BIA) has been suggested as an alternative to less reliable subjective and biochemical indicators of hydration status. The present study aimed to compare various BIA models in the prediction of direct measures of body compartments associated with hydration/osmolality. Fish (n = 20) was selected as a biological model for physicochemically measuring proximate body compartments associated with hydration such as water, dissolved proteins, and non-osseous minerals as the references or criterion points. Whole-body and segmental/local impedance measures were used to investigate a pool of BIA models, which were compared by Akaike Information Criterion in their ability to accurately predict the body components. Statistical models showed that ‘volumetric-based’ BIA measures obtained in parallel, such as distance2/Rp, could be the best approach in predicting percent of body moisture, proteins, and minerals in the whole-body schema. However, serially-obtained BIA measures, such as the ratio of the reactance to resistance and the resistance adjusted for distance between electrodes, were the best fitting in predicting the compartments in the segmental schema. Validity of these results should be confirmed on humans before implementation in practice.

scholarly journals Ichthyometry and electrical bioimpedance analysis to estimate the body composition of tambatinga

2014 ◽  
Vol 44 (2) ◽  
pp. 279-286 ◽  
Author(s):  
Francisco Teixeira Andrade ◽  
Márvio Lobão Teixeira de Abreu ◽  
João Batista Lopes ◽  
Agustinho Valente de Figueiredo ◽  
Maria de Nazaré Bona Alencar Araripe ◽  
...  
Keyword(s):  
Body Composition ◽  
Water Content ◽  
Correlation Coefficients ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
The Body ◽  
Composition Analysis ◽  
Average Weight ◽  
Electrical Bioimpedance ◽  
The Relationship

Body composition analysis is relevant to characterize the nutritional requirements and finishing phase of fish. The aim of this study was to investigate the relationship between ichthyometric (weight, total and standard length, density and yields), bromatological (fat, protein, ash and water content) and bioelectrical-impedance-analysis (BIA) (resistance, reactance, phase angle and composition indexes) variables in the hybrid tambatinga (Colossoma macropomum × Piaractus brachypomus). In a non-fertilized vivarium, 520 juveniles were housed and fed commercial rations. Then, 136 days after hatching (DAH), 15 fish with an average weight of 37.69 g and average total length of 12.96 cm were randomly chosen, anesthetized (eugenol) and subjected to the first of fourteen fortnightly assessments (BIA and biometry). After euthanasia, the following parts were weighed: whole carcass with the head, fillet, and skin (WC); fillet with skin (FS); and the remainder of the carcass with the head (CH). Together, FS and CH were ground and homogenized for the bromatological analyses. Estimates of the body composition and yields of tambatinga, with models including ichthyometric and BIA variables, showed correlation coefficients ranging from 0.81 (for the FS yield) to 1,00 (for the total ash). Similarly, models that included only BIA variables had correlation coefficients ranging from 0.81 (FS and CH yields) to 0.98 (for the total ash). Therefore, in tambatinga, the BIA technique allows the estimation of the yield of the fillet with skin and the body composition (water content, fat, ash, and protein). The best models combine ichthyometric and BIA variables.

Bioelectrical impedance analysis of the body composition of children and adolescents with sickle cell disease

2002 ◽  
Vol 140 (6) ◽  
pp. 681-687 ◽  
Author(s):  
Dorothy J. VanderJagt ◽  
Paul Harmatz ◽  
Ajovi B. Scott-Emuakpor ◽  
Elliot Vichinsky ◽  
Robert H. Glew
Keyword(s):  
Body Composition ◽  
Sickle Cell Disease ◽  
Children And Adolescents ◽  
Sickle Cell ◽  
Bioelectrical Impedance Analysis ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
The Body ◽  
Cell Disease

P1185LUNG COMETS AND EVALUATION OF HYDRATION STATUS IN PERITONEAL DIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Robert Ekart ◽  
Lucijan Lucic Srajer ◽  
Katharina Marko ◽  
Nina Hojs ◽  
Sebastjan Bevc ◽  
...  
Keyword(s):  
Body Composition ◽  
Peritoneal Dialysis ◽  
The Body ◽  
Whole Body ◽  
Fluid Distribution ◽  
Hydration Status ◽  
Non Invasive ◽  
Fluid Status ◽  
Multifrequency Bioimpedance ◽  
Dialysis Vintage

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) &gt; 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 &lt; 0.0001). In contrast, there was no significant correlation between the number of lung comets and UIVC (r = 0.221, P &lt; 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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