A new technique for establishing dry weight in hemodialysis patients via whole body bioimpedance
A new technique for establishing dry weight in hemodialysis patients via whole body bioimpedance
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DOI：
10.1046/j.1523-1755.2002.00377.x
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发表时间：
2002-06-01
影响因子：
19.6
通讯作者：
Wizemann, V
中科院分区：
文献类型：
--
作者：
Chamney, PW;Krämer, M;Wizemann, V
Background. Quantitative techniques are necessary to achieve dry weight (DW) in patients with kidney failure. Bioimpedance spectroscopy (BIS) is a non-invasive method that determines the volume of body fluid compartments. The current work evaluates the use of BIS data in hemodialysis patients for the prediction of DW.Methods. A new technique has been devised for the estimation of DW that involves the intersection of two slopes, slope normovolemia (S-NV ) and slope hypervolemia (S-HV ). These slopes characterize the variation in extracellular water (ECW) with body weight (BW) in the states of normovolemia and hypervolemia, respectively. S-NV was established via measurements of ECW and BW in 30 healthy subjects. In a longitudinal study in new hemodialysis patients, successive reduction of post-dialysis weight (PDW) was attempted until clinical signs of normovolemia were presented. Measurements of ECW and BW that were acquired at the beginning of each treatment were used to determine S-HV .Results. S-NV was found to be 0.239 L/kg and 0.214 L/kg for male and female healthy subjects, respectively. A significant DeltaPDW predicted by the new method (-4.98 kg) was highly correlated to the DeltaPDW achieved in the study (-5.85 kg, R = 0.839). Blood pressure was reduced (P < 0.001) and an 86% decrease in antihypertensive agents was achieved.Conclusion. The method of intersecting slopes (S-HV with S-NV ) 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.
