A new technique for establishing dry weight in hemodialysis patients via whole body bioimpedance

Abstract

The method of intersecting slopes (SHV with SNV) via BIS is a new method for the prediction DW. This approach will offer considerable improvement for the routine management of DW in the dialysis setting.

Development and Validation of Bioimpedance Analysis Prediction Equations for Dry Weight in Hemodialysis Patients

“…(19). Actually, several approaches to DW prediction and to optimization of fluid removal during HD using BIA have been shown to be successful (2,(11)(12)(13); furthermore, very recently, an equivalence of information in fluid monitoring during HD, using measurements at 50 Khz, conventional series circuit, versus bioimpedance spectroscopy with Cole and Hanai model was demonstrated (20). Therefore, the answer to the question of whether technology (BIA) can solve the clinical problem of DW is definitely yes, as outlined by Schneditz in a very recent editorial comment (21): ".…”

“…For more than 20 yr, bioelectrical impedance analysis (BIA) has been recognized as a noninvasive and simple technique to measure body hydration status of patients and has gained much attention for the determination of DW in HD patients (10 -13). Several approaches to DW determination using BIA have been developed, such as the resistance reactance graph (11), the normovolemia/hypervolemia slope method (12), and the continuous calf bioimpedance (13). The first method offers a combined rapid assessment of hydration status and nutritional status within one graph (11).…”

“…It does not, however, provide an absolute number for DW. The second method predicts an absolute DW from one multifrequency bioimpedance spectroscopy measure (12). It does, however, await further refinements (1).…”

Insulin Resistance in Nondiabetic Peritoneal Dialysis Patients

“…The bioimpedance method applied was validated by isotope dilution methods (15), by accepted reference body composition methods (16,17), and by extensive clinical assessment of the hydration state (18). Body composition assessments were done with full abdomen during the PET procedure, taking into account the fact that the patient was weighed after draining out peritoneal effluent and thereafter 2 liters of peritoneal solution were instilled.…”

Bioimpedance Measurement in the Kidney Disease Patient

“…Three approaches have been particularly fruitful, the nomovolemia/hypervolemia curves established by Chamney [46,47,48,49], the resistance/reactance curves by Piccoli [50,51,52] and Zhu's continuous curves [53,54]. Although essential, these approaches will not be detailed here.…”