Body Composition, Hydration, and Related Parameters in Hemodialysis versus Peritoneal Dialysis Patients

2010 ◽  
Vol 30 (2) ◽  
pp. 208-214 ◽  
Author(s):  
Isabel Devolder ◽  
Annick Verleysen ◽  
Denise Vijt ◽  
Raymond Vanholder ◽  
Wim Van Biesen
Keyword(s):  
Body Composition ◽  
Peritoneal Dialysis ◽  
Volume Overload ◽  
Volume Status ◽  
Extracellular Water ◽  
Multivariate Models ◽  
Dialysis Patients ◽  
Multifrequency Bioimpedance ◽  
Total Body ◽  
Composition Monitoring

AimsMaintaining euvolemia is an important goalin patients on renal replacement therapy. However, adequate assessment of volume status in clinical practice is hampered by a lack of accurate measuring tools. A new multifrequency bioimpedance tool has recently been validated. This study compares volume status in peritoneal dialysis (PD) and hemodialysis (HD) patients in a single center.MethodsBody Composition Monitoring (BCM; Fresenius Medical Care, Bad Homburg, Germany) was performed in all patients on PD or HD without contraindication. PD patients were measured with a full abdomen; HD patients were measured at the midweek session, once immediately before and once 20 minutes after dialysis. Clinical overhydration was defined as an overhydration-to-extracellular water ratio of >0.15.ResultsTotal body water, extracellular water, and intracellular water were 33.7 ± 6.9 L versus 31.8 ± 8.1 L vs 33.9 ± 6.7 L, 16.4 ± 3.9 L vs 15.3 ± 4.9 L vs 16.8 ± 3.3 L, and 17.1 ± 6.2 L vs 16.5 ± 4.6 L vs 17.2 ± 3.9 L in the pre-HD, post-HD, and PD patients, respectively ( p = NS). In the pre-HD and the PD patients, overhydration was 1.9 ± 1.7 L and 2.1 ± 2.3 L, whereas post-HD this was only 0.6 ± 1.7 L ( p < 0.001). Clinical overhydration was more prevalent in pre-HD and PD patients compared to post-HD patients (24.1% vs 22.3% vs 10%, p < 0.001). In multivariate models, overhydration was related to age, male gender, and post-HD status.ConclusionAlthough much clinical attention is paid to volume status, 24% of patients still have clinically relevant volume overload. Implementation of a reliable and clinically applicable tool to assess volume status is therefore necessary. It is possible to obtain comparable volume status in PD and HD patients.

scholarly journals Předsoutěžní redukce tělesné hmotnosti a její vliv na tělesné složení

2013 ◽  
Vol 7 (1) ◽  
pp. 121-126
Author(s):  
Klára Coufalová ◽  
Ivana Kinkorová ◽  
Lucia Malá ◽  
Jan Heller
Keyword(s):  
Body Composition ◽  
Body Weight ◽  
Weight Reduction ◽  
Negative Impact ◽  
Fat Free Mass ◽  
Extracellular Water ◽  
The Czech Republic ◽  
Body Weight Reduction ◽  
Multifrequency Bioimpedance ◽  
Total Body

The aim of our study was to monitor changes in individual components of body composition due to reduction in body weight in judo. This precontest weight reduction is very common in combat sports and it can have negative impact not only on performance but also on health. Research group consisted of 11 judoists at the age of 17-27 years belonging to the representation of the Czech Republic. The measurement of body composition had two parts; the first was before body weight reduction and the second part at the end of body weight reduction. For the measurement of body composition we used multifrequency bioimpedance analyzer BIA 2000 - M. The results of our study show that rapid intensive weight reduction is reflected in varying degrees in all parameters of body composition. We noticed a reduction of body weight by an average of 4.7% (approximately 3.8 kg), the weight loss ranged from 1.6 kg to 8.1 kg. The greatest changes in the parameters of body composition were detected in the extracellular water (ECW), there was a decrease of this parameter on average by 13.8 %, while total body water (TBW) decreased by 6.0 %. There was also a reduction in the amount of body fat by 13.2 %, the amount of extracellular mass (ECM) decreased by 9.8 %, the ratio of ECM/BCM by 8.9 % and the amount of fat-free mass (FFM) decreased by 4.0 %. Only in intracellular water (ICW), we noticed a slight increase by 1.4 %, which may be due to the redistribution of body fluids. Changes of particular parameters of body composition were statistically and substantively significant.

MO712EVALUATION OF VOLUME OVERLOAD STATUS MARKERS IN PERITONEAL DIALYSIS PATIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
João Carvão ◽  
Adriana Fernandes ◽  
Rita Veríssimo ◽  
Rita Calça ◽  
Ana Rita Martins ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Ejection Fraction ◽  
Multivariable Analysis ◽  
Volume Overload ◽  
Left Ventricular ◽  
Hydration Status ◽  
Dialysis Patients ◽  
Multifrequency Bioimpedance ◽  
Lv Mass ◽  
Lv Ejection Fraction

Abstract Background and Aims N-terminal fragment of B-type natriuretic peptide (NT-proBNP) can reflect changes in hydration status and may help the nephrologist to estimate it. Fluid volume overload is a major concern in dialysis patients, and it is associated with increased cardiovascular risk and death. This study evaluated the relationship between serum NT-proBNP levels and left ventricular (LV) dysfunction and extra-cellular excess water in peritoneal dialysis patients. Method We conducted a cross-sectional study of 60 peritoneal dialysis (PD) patients. Incident and prevalent patients were included. Echocardiography was performed using HDI 5000, allowing M-mode, two-dimensional measurement. A multifrequency bioimpedance (BIA) analyzer was used. Overhydration (OH) was defined as an extra-cellular water (ECW)/total body water (TBW) over 15%. Clinical and biochemical variables were also analysed. Results A total of 60 patients were evaluated (male 60% (n=36), mean age was 55,8 ± 15,3 years, BMI 25.9 ± 3.9 kg/m2 and 31.7% (n=19) had diabetes mellitus (DM). Median PD vintage was 21 months, automated PD 30%, 8.3% (n=5) were anuric and 10% (n=6) were overhydrated. The median serum NT-proBNP level was 1071 pg/mL. LV mass index and LV ejection fraction were 129.0 ± 51.1 g/m2 and 62.8 ± 13.0%, respectively. The median excess volume overload was 0.9L. Serum NT-proBNP levels correlated positively with, diabetes (r=0.27, p=0.04), isquemic cardiopathy (r=0.37, p=0.01), LV mass index (r=0.48, p=0.001) and extracellular water (r=0.31, p=0.02) and negatively with LV ejection fraction (r= -0.81, p=0.01). In a multivariable analysis, in a model adjusted to time in DP, diabetes, residual diuresis, isquemic cardiopathy and left ventricle mass index, NT-proBNP &gt; 1600 pg/mL was associated with patient overhidratation (exp (B) 1,44, 95% CI 0,15-2.73). No statistical difference was observed considering nutritional parameters, peritoneal transport, dialysis efficacy and NT-proBNP. Conclusion In this population, higher levels of NT-proBNP were associated with overhydration status and left ventricular dysfunction. Therefore, BIA and NT-proBNP may be complementary to clinical evaluation of PD patients. BIA results can be affected by malnutrition with loss of cell mass according to some studies. In our population NT-proBNP is not affected by nutritional status and therefore can also be used as a congestive marker in malnourished patients. Longitudinal application of BIA could be a useful clinical tool to evaluate adequacy in PD patients.

scholarly journals Fluid Status in Peritoneal Dialysis Patients: The European Body Composition Monitoring (EuroBCM) Study Cohort

PLoS ONE ◽  
2011 ◽  
Vol 6 (2) ◽  
pp. e17148 ◽  
Author(s):  
Wim Van Biesen ◽  
John D. Williams ◽  
Adrian C. Covic ◽  
Stanley Fan ◽  
Kathleen Claes ◽  
...  
Keyword(s):  
Body Composition ◽  
Peritoneal Dialysis ◽  
Study Cohort ◽  
Dialysis Patients ◽  
Fluid Status ◽  
Composition Monitoring
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