Assessment of volume status with bioimpendance prior to hemodialysis and its importance for predicting survival in hemodialysis patients
Abstract
BACKGROUND: Optimal fluid management is a physician's everyday challenge in patients on maintenance hemodialysis (HD). Bioimpedance spectroscopy (BIS) is a non-invasive method to estimate body composition, including estimates of fluid overload (FO). Our study aimed to analyze the association between FO and the mortality rate in HD patients. MATERIALS AND METHODS: We performed a retrospective single-center cohort study in 92 HD patients. The body composition was measured before HD using the portable whole-body BIS device Body Composition Monitor (BCM). We have analyzed the mortality rates of HD patients in two FO groups, a standard definition FO group (> 1.1 L), and a severe FO group (> 2.5 L) and compared them to mortality rates of patients without FO or without severe FO, respectively. RESULTS: The mean age of patients was 64.3 ± 13.0 years, mean dialysis vintage 64 months, 60.9% were men. 68 (73.9%) patients had FO of > 1.1 L and 30 (32.6%) had FO of > 2.5 L. During the follow-up period of 1,020 ± 417 days, 29 (31.5%) patients died. Kaplan-Meier survival analysis showed that patients with FO > 2.5 L had worse survival (p = 0.039). In a Cox regression model, which included FO > 2.5 L, age, dialysis vintage, hemoglobin, C-reactive protein, and albumin, only FO > 2.5 L and advanced age turned out to be predictors of death (p = 0.044 and p = 0.001, respectively). CONCLUSION: HD patients with FO > 2.5 L before HD have poorer survival than patients with normohydration or lower overhydration.
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Approximately 30%-37% of haemodialysis patients have water retention, and excessive fluid volume is closely related to difficulty correcting haemodialysis-related complications and is a major factor affecting patient death.
“Approximately 30% ~ 37% of haemodialysis patients have water retention, and excessive fluid volume is closely related to difficulty correcting haemodialysis‐related complications and is a major factor affecting patient death (Fernandes et al., 2021; Keber et al., 2021).”
From Construction of haemodialysis nursing‐sensitive quality indicators based on Donabedian theory: A Delphi method study (2023) · cites this paper as Keber et al., 2021
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Chen, L., Zhang, Y., Li, C., Li, Q., & He, L. (2023) · Nursing Open · doi:10.1002/nop2.1349 · Cited by 28 · see citing works
“Approximately 30% ~ 37% of haemodialysis patients have water retention, and excessive fluid volume is closely related to difficulty correcting haemodialysis- related complications and is a major factor affecting patient death (Fernandes et al., 2021; Keber et al., 2021).”
Background
- Authors
- Keber, G., Hojs, R., Dvoršak, B., Bevc, S., Hojs, N. V., Petreski, T., & Ekart, R.
- Venue
- Clinical Nephrology
- Publisher
- Dustri-Verlgag Dr. Karl Feistle
- Published
- 2021-01-01
- Volume
- 96
- Issue
- Suppl 1
- Pages
- 68-73
- ISSN
- 0301-0430 (ISSN-L)
- OpenAlex
- W3205759458
- Cited by
- 6
- References
- 0
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 1 · 2022: 3
- FWCI
- 0.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Nephrology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Keywords
- fluid overload, maintenance hemodialysis, bioimpedance spectroscopy, body composition, volume status assessment, mortality prediction, survival, fluid management, end-stage renal disease
- MeSH terms
- Aged, Body Composition, Renal Dialysis, Humans, Kidney Failure, Chronic, Male, Middle Aged, Retrospective Studies, Water-Electrolyte Imbalance, Cohort Studies
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