The relationship between chronic volume overload and elevated blood pressure in hemodialysis patients: use of bioimpedance provides a different perspective from echocardiography and biomarker methodologies

Voroneanu, Luminița; Cusai, Claudiu; Hogaş, Simona; Ardeleanu, Serban; Onofriescu, Mihai; Nistor, Ionuţ; Prisada, Octavian; Sascău, Radu Andy; Goldsmith, David; Covic, Adrian

doi:10.1007/s11255-010-9767-y

Cited by 58 publications

(53 citation statements)

References 31 publications

(39 reference statements)

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“…For each patient, we recorded episodes of intradialytic symptomatic hypotension in the previous 3 dialysis sessions. The device for BIS was the Body Composition Monitor (Fresenius Medical Care D, Bad Homburg, Germany) [8] , and for US it was the Power Vision 6000 (SSA-370A, Toshiba, Tokyo, Japan) with a 3.75-Mhz probe. The patients' dry weight was considered the prescribed weight.…”

Section: Methodsmentioning

confidence: 99%

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Comparison and Reproducibility of Techniques for Fluid Status Assessment in Chronic Hemodialysis Patients

Basso

Manani²,

Cruz³

et al. 2013

Cardiorenal Med

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Background: Several methods have been developed to assess the hydration status in chronic hemodialysis (HD) patients. The aim of this study was to compare body bioimpedance spectroscopy (BIS) with ultrasound (US) lung comet score (ULCs), B-type natriuretic peptide (BNP) and inferior vena cava diameter (IVCD) by US for the estimation of dry weight before and after HD and to analyze all methods in terms of fluid status variations induced by HD. An additional aim of this study was to establish the interoperator reproducibility of these methods. Methods: Two nephrologists evaluated BIS, ULCs, IVCD during inspiration (min) and expiration (max), the inferior vena cava collapsibility index (IVCCI) as well as BNP before and after HD in 30 patients. The same operators measured BIS, ULCs and IVCD in 28 HD patients in a blinded fashion. Results: There was a significant reduction in BIS, ULCs, IVCD and BNP after HD (p < 0.001), but a less significant reduction in IVCCI (p = 0.13). There was a significant correlation between BIS and ULCs, BNP and indexed IVCD (IVCDi)min (p < 0.05) before and after HD, and between BIS and IVCDimax only before HD. Conclusion: All methods were able to describe hyperhydration before and after HD, except for IVCCI after HD. All techniques correlated with BIS before HD. After HD, ULCs correlated better with BIS than IVCD in terms of evaluation of fluid status. It could be expected that the ULCs can give a real-time evaluation of interstitial water. The reproducibility of the measurement of BIS, IVCD and ULCs between the two operators was high.

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Section: Methodsmentioning

confidence: 99%

“…Body bioimpedance spectroscopy (BIS) is a multifrequency bioimpedance [8,9] . BNP is a peptide synthesized and stored in cytoplasmatic vesicles of myocytes; its levels raise with ventricular stretch, caused by pressure or volume overload [10] .…”

Section: Introductionmentioning

confidence: 99%

Comparison and Reproducibility of Techniques for Fluid Status Assessment in Chronic Hemodialysis Patients

Basso

Manani²,

Cruz³

et al. 2013

Cardiorenal Med

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“…28 Fluid overload was defined as the excess of fluids (l) in the whole-body as assessed by using the BCM device.…”

Section: Assessment Of the Hydration Statusmentioning

confidence: 99%

The impact of the peritoneal glucose load index on hydration status and inflammation in peritoneal dialysis patients

Hassan

Edgem

et al. 2014

J Int Med Res

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Objective: To evaluate the impact of the peritoneal glucose load (PGL) on hydration status and inflammation in peritoneal dialysis (PD) patients. Methods: This cross-sectional study evaluated stable PD patients using a novel PGL index (PGLI), which was calculated as the net glucose content (g) in the PD solutions administered in the daily PD prescription divided by the dry body weight (kg) assessed by whole-body bioimpedance spectroscopy. The relationship between PGLI and glycosylated haemoglobin (HbA 1c ), fluid overload (FO), and inflammatory markers was investigated. Results: A total of 43 stable PD patients participated in the study. Significant positive correlations were found between PGLI and HbA 1c , FO, plasma high sensitivity C-reactive protein (hsCRP), and plasma interleukin-6 (IL-6) levels. HbA 1c , FO, plasma hsCRP and plasma IL-6 levels were significantly higher in patients with PGLI >3 g/kg/day compared with those with PGLI 3 g/kg/day. Conclusions: PGLI values >3 g/kg/day may be associated with poor glycaemic control, over hydration and augmented inflammation. PGLI might be a useful tool for the quantitative assessment of the PGL and could be applied when managing PD patients.

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“…It should be acknowledged that the definition of resistant hypertension in the population of HD patients is not applicable due to the lack of diuretics efficacy in oliguric/anuric patients. Hypertension in HD patients often reflects inadequate volume control [6], and preservation of fluid in the extracellular space [7]. It should be stressed that the clinical assessment of volaemia could raise significant difficulties as up to now, there is the lack of simple reliable, validated, clinically applicable method for volume assessment in HD patients.…”

Section: Introductionmentioning

confidence: 99%

“…Bioimpedance allows quantification of excess extracellular volume by comparison with a healthy population. This safe and noninvasive method can be used to determine hydration status in patients on dialysis therapy, and different from other methods allows the quantification of intracellular and extracellular volumes [6,10,11]. However, this approach is time-consuming and difficult to handle in everyday practice.…”

Section: Introductionmentioning

confidence: 99%

N-Terminal Prohormone of Brain Natriuretic Peptide but not C-Terminal Pre-Pro Vasopressin (Copeptin) Level is Associated with the Response to Antihypertensive Therapy in Haemodialysis Patients

Wyskida

Ficek

et al. 2017

Kidney Blood Press Res

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Background/Aims: Volume overload, frequently clinically asymptomatic is considered as a causative factor limiting the effectiveness of antihypertensive therapy in haemodialysis (HD) patients. Therefore, the aim of this study was to assess plasma levels of N-terminal fragment of the prohormone brain natriuretic peptide (NT-proBNP) and a C-terminal portion of the precursor of vasopressin (CT-proAVP, copeptin) The highest NT-proBNP values were observed in patients receiving 3 or more antihypertensive drugs. In contrast, no significant correlation was found between plasma CT-proAVP concentrations and BP values as well as and the number of antihypertensive drugs. Receiver operator curve analysis showed that NT-proBNP values over 13,184 pg/mL predicted the use of at least 3 antihypertensive drugs in maximal doses in the therapy of hypertension, similar analyses performed for CTproAVP showed much less specificity. Conclusions: 1. Increased levels of NT-proBNP seems to be a better biomarker of multidrug antihypertensive therapy requirement than CT-proAVP. 2. Whether estimation of NT-proBNP in these patients will be also better biomarker than copeptin in the prediction of cardiovascular complications related to hypertension needs further investigations.

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The relationship between chronic volume overload and elevated blood pressure in hemodialysis patients: use of bioimpedance provides a different perspective from echocardiography and biomarker methodologies

Cited by 58 publications

References 31 publications

Comparison and Reproducibility of Techniques for Fluid Status Assessment in Chronic Hemodialysis Patients

Comparison and Reproducibility of Techniques for Fluid Status Assessment in Chronic Hemodialysis Patients

The impact of the peritoneal glucose load index on hydration status and inflammation in peritoneal dialysis patients

N-Terminal Prohormone of Brain Natriuretic Peptide but not C-Terminal Pre-Pro Vasopressin (Copeptin) Level is Associated with the Response to Antihypertensive Therapy in Haemodialysis Patients

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