Bioimpedance-Guided Fluid Management in Maintenance Hemodialysis: A Pilot Randomized Controlled Trial

Onofriescu, Mihai; Hogaş, Simona; Voroneanu, Luminița; Apetrii, Mugurel; Nistor, Ionuţ; Kanbay, Mehmet; Covic, Adrian

doi:10.1053/j.ajkd.2014.01.420

Cited by 215 publications

(247 citation statements)

References 20 publications

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“…There is recent randomized trial evidence in hemodialysis patients showing that fluid management guided by a bioimpedance device that provides an estimate of the degree of overhydration may be associated with a reduction in left ventricular hypertrophy and an improvement in blood pressure control and pulse wave velocity (7). Another randomized controlled study also showed an improvement in patient survival (8). However, similar evidence of bioimpedance or guided fluid management is completely lacking in PD patients.…”

Section: No 4 Part I -Management Of Various Cardiovascular Complicmentioning

confidence: 97%

ISPD Cardiovascular and Metabolic Guidelines in Adult Peritoneal Dialysis Patients Part I – Assessment and Management of Various Cardiovascular Risk Factors

et al. 2015

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Section: No 4 Part I -Management Of Various Cardiovascular Complicmentioning

confidence: 97%

ISPD Cardiovascular and Metabolic Guidelines in Adult Peritoneal Dialysis Patients Part I – Assessment and Management of Various Cardiovascular Risk Factors

et al. 2015

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“…Bioelectrical impedance analysis (BIA) is a method of assessing ECF status by measuring the impedance of the body to applied electric currents of different frequencies 9, 10. Accumulating evidence suggests that strict BIA‐guided fluid management has a beneficial impact on blood pressure, arterial stiffness, left ventricular hypertrophy, and survival in patients undergoing dialysis 11, 12…”

Section: Introductionmentioning

confidence: 99%

Extracellular Fluid Excess Is Significantly Associated With Coronary Artery Calcification in Patients With Chronic Kidney Disease

Park

Jhee

Yun

et al. 2018

JAHA

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BackgroundExtracellular fluid (ECF) excess is an independent predictor of cardiovascular morbidity in patients undergoing dialysis. This study aimed to investigate the relationship between ECF status, which is affected by renal function, and coronary artery calcification (CAC), which is a marker of cardiovascular disease, in patients with chronic kidney disease (CKD).Methods and ResultsA total of 1741 patients at all stages of pre‐dialysis CKD from the prospective observational cohort of CMERC‐HI (Cardiovascular and Metabolic Disease Etiology Research Center‐High Risk) were analyzed for the association between ECF status and CAC. ECF status was defined as extracellular water‐to‐total body water ratio (ECW/TBW) measured using bioelectrical impedance analysis. ECF excess was defined as ECW/TBW ≥0.390 or ≥0.400 depending on its severity. To define CAC, Agatston coronary artery calcium scores were measured. A total coronary artery calcium score of ≥400 was defined as CAC. The CKD stages were defined according to estimated glomerular filtration rate calculated using the CKD Epidemiology Collaboration equation. ECW/TBW and the proportion of ECF excess increased with progressing CKD stages. Multivariable logistic regression analyses showed that ECW/TBW was independently associated with CAC (per 0.01 increase of ECW/TBW, odds ratio 1.168, 95% confidence interval, 1.079–1.264, P<0.001). The adjusted R 2 for predicting higher coronary artery calcium scores and CAC significantly improved after ECW/TBW was added to conventional factors. This association was further confirmed by net reclassification and integrated discriminant improvements, sensitivity analysis, and subgroup analysis.Conclusions ECF status is independently associated with a high risk of CAC in patients with CKD.Study Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT02003781.

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“…1,2 Bioimpedance is considered to be a sensitive tool for measuring body fluid composition; however, the interpretation of this data is difficult. The raw impedance data, consisting of resistance and reactance values, are abstract, and provide only indirect information on extraand intracellular fluid volumes.…”

mentioning

confidence: 99%

The effect of crystalloid infusion on body water content and intra-abdominal pressure in patients undergoing orthopedic surgery under spinal anesthesia

Kotlińska-Hasiec¹,

Rutyna²,

Rzecki³

et al. 2017

Adv Clin Exp Med

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Bioimpedance-Guided Fluid Management in Maintenance Hemodialysis: A Pilot Randomized Controlled Trial

Cited by 215 publications

References 20 publications

ISPD Cardiovascular and Metabolic Guidelines in Adult Peritoneal Dialysis Patients Part I – Assessment and Management of Various Cardiovascular Risk Factors

ISPD Cardiovascular and Metabolic Guidelines in Adult Peritoneal Dialysis Patients Part I – Assessment and Management of Various Cardiovascular Risk Factors

Extracellular Fluid Excess Is Significantly Associated With Coronary Artery Calcification in Patients With Chronic Kidney Disease

The effect of crystalloid infusion on body water content and intra-abdominal pressure in patients undergoing orthopedic surgery under spinal anesthesia

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