Use of Multifrequency Bioimpedance Analysis in Male Patients with Acute Kidney Injury Who Are Undergoing Continuous Veno-Venous Hemodiafiltration

Abstract

IntroductionFluid overload is a well-known predictor of mortality in patients with acute kidney injury (AKI). Multifrequency bioimpedance analysis (MF-BIA) is a promising tool for quantifying volume status. However, few studies have analyzed the effect of MF-BIA-defined volume status on the mortality of critically ill patients with AKI. This retrospective medical research study aimed to investigate this issue.MethodsWe retrospectively reviewed the medical records of patients with AKI who underwent continuous veno-venous hemodiafiltration (CVVHDF) from Jan. 2013 to Feb. 2014. Female patients were excluded to control for sex-based differences. Volume status was measured using MF-BIA (Inbody S20, Seoul, Korea) at the time of CVVHDF initiation, and volume parameters were adjusted with height squared (H2). Binary logistic regression analyses were performed to test independent factors for prediction of in-hospital mortality.ResultsA total of 208 male patients were included in this study. The mean age was 65.19±12.90 years. During the mean ICU stay of 18.29±27.48 days, 40.4% of the patients died. The in-hospital mortality rate increased with increasing total body water (TBW)/H2 quartile. In the multivariable analyses, increased TBW/H2 (OR 1.312(1.009-1.705), p=0.043) and having lower serum albumin (OR 0.564(0.346-0.919, p=0.022) were independently associated with higher in-hospital mortality. When the intracellular water (ICW)/H2 or extracellular water (ECW)/H2 was adjusted instead of the TBW/H2, only excess ICW/H2 was independently associated with increased mortality (OR 1.561(1.012-2.408, p=0.044).ConclusionsMF-BIA-defined excess TBW/H2 and ICW/H2 are independently associated with higher in-hospital mortality in male patients with AKI undergoing CVVHDF.

Short- and Long-Term Mortality Rates of Elderly Acute Kidney Injury Patients Who Underwent Continuous Renal Replacement Therapy

“…The prevalence of liver cirrhosis decreased with aging. CRRT was performed as continuous veno-venous hemodiafiltration (CVVHDF) mode, followed by the protocol of our clinic as described in our previous research [15]. The CRRT initiation time and actual delivered dose were not different among the different age cohorts.…”

Discrete Interval Binary Signal Optimization Using PSO

“…A 5.60 % of improvement in the best case would seem small, but talking about signals for system identification every improvement in the input signal will improve the output measurements [2,4,5]. This will also increase the weight of DIBS in the balance when compared with other type of signals.…”

“…There are studies evaluating the quality of these signals and DIBS shows superior characteristics over the rest [1][2][3]. An example where these multi-frequency signals are widely used as input is bioimpedance, allowing fast measurements in multiple frequencies [2,4,5].…”

Bio-electrical impedance analysis in critically ill patients: are we ready for prime time?

“…Bio-electrical impedance analysis (BIA) has gained increased interest to help physicians to determine volume status and fluid distribution in critically ill patients (see Table 1) [1,2,4,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. Indeed, several data published in the last decade suggest that BIA may provide useful information not only in different well-established patient groups (dialysis, AIDS, malnutrition), but also in critically ill patients with burns, trauma or sepsis undergoing fluid resuscitation.…”