A Device for Monitoring Hydration State in Hemodialysis Patients Using a Calf Bioimpedance Technique

Zhu, Fansan; Kuhlman, Martin; Kotanko, Peter; Handelman, Garry J.; Leonard, Edward F.; Levin, Nathan W.

doi:10.1007/978-3-540-73841-1_200

Cited by 6 publications

(2 citation statements)

References 4 publications

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“…We hypothesize that during dialysis segments such as the arm or trunk will achieve normal hydration before the calf. We have reported that the curve of calf resistance measured continuously during dialysis flattens when patients are close to DW (Zhu et al 2004(Zhu et al , 2007. In order to confirm the degree of hydration, we suggested that the measurement of change in electrical resistivity in the calf compared with normal subjects be combined with the curve of resistance hydration (Kuhlmann et al 2005).…”

Section: Hypothesis For the Assessment Of Dry Weight Using Calf Resis...mentioning

confidence: 99%

A method for the estimation of hydration state during hemodialysis using a calf bioimpedance technique

et al. 2008

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Although many methods have been utilized to measure degrees of body hydration, and in particular to estimate normal hydration states (dry weight, DW) in hemodialysis (HD) patients, no accurate methods are currently available for clinical use. Biochemcial measurements are not sufficiently precise and vena cava diameter estimation is impractical. Several bioimpedance methods have been suggested to provide information to estimate clinical hydration and nutritional status, such as phase angle measurement and ratio of body fluid compartment volumes to body weight. In this study, we present a calf bioimpedance spectroscopy (cBIS) technique to monitor calf resistance and resistivity continuously during HD. Attainment of DW is defined by two criteria: (1) the primary criterion is flattening of the change in the resistance curve during dialysis so that at DW little further change is observed and (2) normalized resistivity is in the range of observation of healthy subjects. Twenty maintenance HD patients (12 M/8 F) were studied on 220 occasions. After three baseline (BL) measurements, with patients at their DW prescribed on clinical grounds (DW(Clin)), the target post-dialysis weight was gradually decreased in the course of several treatments until the two dry weight criteria outlined above were met (DW(cBIS)). Post-dialysis weight was reduced from 78.3 +/- 28 to 77.1 +/- 27 kg (p < 0.01), normalized resistivity increased from 17.9 +/- 3 to 19.1 +/- 2.3 x 10(-2) Omega m(3) kg(-1) (p < 0.01). The average coefficient of variation (CV) in three repeat measurements of DW(cBIS) was 0.3 +/- 0.2%. The results indicate that cBIS utilizing a dynamic technique continuously during dialysis is an accurate and precise approach to specific end points for the estimation of body hydration status. Since no current techniques have been developed to detect DW as precisely, it is suggested as a standard to be evaluated clinically.

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Section: Hypothesis For the Assessment Of Dry Weight Using Calf Resis...mentioning

confidence: 99%

A method for the estimation of hydration state during hemodialysis using a calf bioimpedance technique

et al. 2008

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“…2,14 -16 Different ratios of change for the impedance at different stages of the dialysis treatment and possible relation with the amount of fluid overload have been already reported in the literature. 15 In this article, the use of knee-to-knee (KK) BIS measurements for continuous monitoring during hemodialysis is introduced and compared with typical WA measurements. Measurements on patients, while trying not to interfere with the course of the treatment and the comfort of the patient, and physiological simulations have been used for the evaluation.…”

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confidence: 99%

A Novel Bioimpedance Technique to Monitor Fluid Volume State During Hemodialysis Treatment

Medrano¹,

Eitner²,

Floege³

et al. 2010

ASAIO Journal

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Bioimpedance spectroscopy is a potential candidate for monitoring of body fluids during dialysis. In this article, the suitability of knee-to-knee (KK) as an alternative to wrist-to-ankle (WA) bioimpedance spectroscopy measurements during dialysis is evaluated. Measurements on eight patients (22 dialysis sessions) showed a good correlation between the change in extracellular resistance (Re) in KK and WA measurements. A deeper analysis indicated that the change in Re normalized for ultrafiltrated volume [DeltaRe/UFV (%/L)] depends on the characteristics of the patient: clinically stable patients [with a presumed lower extracellular fluid - total body volume (VB) relationship] show a higher DeltaRe/UFV (%/L) mean +/- standard deviation (WA: 8.90 +/- 1.9 and KK: 8.29 +/- 2.2) than clinically unstable patients with pitting peripheral edema (WA: 2.10 +/- 0.8 and KK: 2.07 +/- 0.2). Simulations based on bioimpedance equations considering Hanai theory confirm the results. The KK method, especially in combination with proper use of the introduced DeltaRe/UFV (%/L) normalization could possibly offer new options for comfortable online monitoring and the evaluation of fluid volume state during dialysis.

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Body Composition by Bioelectrical Impedance Analysis

González-Correa

2018

Bioimpedance in Biomedical Applications and Research

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A Device for Monitoring Hydration State in Hemodialysis Patients Using a Calf Bioimpedance Technique

Cited by 6 publications

References 4 publications

A method for the estimation of hydration state during hemodialysis using a calf bioimpedance technique

A method for the estimation of hydration state during hemodialysis using a calf bioimpedance technique

A Novel Bioimpedance Technique to Monitor Fluid Volume State During Hemodialysis Treatment

Body Composition by Bioelectrical Impedance Analysis

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