Background and Aims
Fluid status evaluation is essential to adjust the dry weight(DW) in chronic hemodialysis (HD) patients. Bioelectric impedance is a non invasive technique. Its contribution in HD population is well demonatrated. The aim of this study is to compare evaluation of fluid status clinically and by bioimpedance analysis.
Method
It’s a transversal study conducted in December 2018.We included chronic dialysis patients( for more 3 months) having 3 dialysis sessions(DS) a week. Bioimpedance analysis (BIA) was performed before and after DS.
Results
There were 26 patients with an average age of 51,4 years. Sex ratio was 3,33 . Average period spent in HD was 73,7 months. Vascular access was a native arteriovenous fistula in 24 patients, and a catheter in 2 patients. Seven patients had residual diuresis. Average ultrafiltration rate was 2,82 L (10 mL/Kg/h).
Before DS, 20 patients had no clinical signs of fluid overload. Unconformity with BIA was noted in 12 patients, with a subclinical overload in all cases. Six patients had clinical signs of fluid overload (including hypertension (HT) in 5 cases), which was concordant with BIA.
After DS, 22 patients reached their DW with a correct hydration status, 2 patients still had clinical signs of fluid overload, and 2 had isolated HTA. BIA revealed the persistence of fluid overload in 10 patients contrasting with the absence of clinical signs of hypervolemia in 8 patients. Patients who kept only HT had a normal hydration status.
Conclusion
Fluid status is an important adequacy issue in the treatment of renal failure. It’s a modifiable risk factor associated to mortality. Bioimpedance analysis is a great help to precise dry weight that must be integrated into our daily practice.
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