Effect of Change in Fluid Status Evaluated by Bioimpedance Techniques on Body Composition in Hemodialysis Patients

Abbas, Samer R.; Thijssen, Stephan; Penne, E. Lars; Raimann, Jochen G.; Liu, Li; Sipahioğlu, Murat Hayri; Seibert, Eric; Wang, Yuedong; Chen, Yuqi; Xiao, Qingqing; Levin, Nathan W.; Kotanko, Peter; Zhu, Fansan

doi:10.1053/j.jrn.2017.09.002

Cited by 9 publications

(8 citation statements)

References 35 publications

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“…Because of the unique characteristics of bone metabolism, more large-scale studies are still needed to find the optimal cutoff value of QUS-T score and BMCI in MHD. BIA is a noninvasive, reliable method of assessing physical status and dry weight, which has been recommended for patients with MHD [19]. BIA can also be used to estimate the BMC, which might be useful for bone density evaluation and monitoring [20].…”

Section: Discussionmentioning

confidence: 99%

Value of quantitative ultrasound and bioelectrical impedance analysis in detecting low bone mineral density in hemodialysis

Xiang

Zhou

et al. 2021

Renal Failure

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Introduction: Patients on maintenance hemodialysis (MHD) are highly predisposed to low bone mineral density (BMD). This study aims to assess the value of quantitative ultrasound (QUS), bioelectrical impedance analysis (BIA), and their combination in detecting high-risk patients for low BMD in MHD. Methods: Patients' BMD of the total hip, femoral neck, and lumbar spine were measured using dual-energy X-ray absorptiometry (DXA). Bone mineral content (BMC) was assessed using BIA. Calcaneal BMD was measured using QUS. Patients with a T-score of -2.5 were recorded as 'low BMD.' Results: Overall, 93 subjects (62.37% female; mean age, 60.8 ± 16.2 years) were included in this cross-sectional study; approximately 36.56% met the 'low BMD' criteria. QUS-T score predicted low BMD with an area under the curve (AUC) value of 0.738, sensitivity of 70.59%, and specificity of 76.27%. The AUC for low BMD diagnosis using the BMC index (BMCI) measured through BIA was 0.679 (sensitivity, 91.18%; specificity, 38.98%). On the other hand, the combination of QUS-T score and BMCI yielded a higher AUC value of 0.762 with an improved specificity of 88.14%. Compared with the QUS and BIA alone, the net reclassification improvement (NRI) of the combination model increased by 47.16% (p ¼ 0.022) and 78.36% (p < 0.0001), respectively. Integrated discrimination improvement (IDI) increased by 5.25% (p ¼ 0.043) and 9.99% (p ¼ 0.003), respectively. QUS-T score and BMCI were related to BMD independently assessed by DXA. Conclusion:The combination of QUS and BIA is effective in screening for low BMD among MHD patients.

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Section: Discussionmentioning

confidence: 99%

Value of quantitative ultrasound and bioelectrical impedance analysis in detecting low bone mineral density in hemodialysis

Xiang

Zhou

et al. 2021

Renal Failure

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“…A análise de bioimpedância (BIA) é um método importante e não invasivo para avaliar a composição corporal, e tem sido validado em diferentes populações, incluindo pacientes em diálise [6][7][8][9][10] . As medições de BIA e ângulo de fase (PhA) fornecem informações sobre distribuição de volume e estado nutricional, melhorando a avaliação de desnutrição, fragilidade e sarcopenia [11][12][13] .…”

Section: Antecedentesunclassified

“…O outro foi de pacientes jovens não diabéticos que não seguem as recomendações de restrição dietética. Abbas et al 10 descobriram que pacientes diabéticos apresentaram uma eficiência significativamente menor na remoção de líquidos durante a diálise, possivelmente devido ao comprometimento do reenchimento vascular.…”

Section: Excesso De Fluidos Pressão Arterial E Mortalidadeunclassified

Bioimpedanciometria em avaliações nutricionais e de hidratação em um único centro de diálise

et al. 2023

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RESUMO Antecedentes: Análise de bioimpedância (BIA) demonstrou adicionar acurácia às avaliações de estado nutricional e de volume em pacientes em diálise (HD). Objetivo: descrever amostra de pacientes em diálise de um único centro quanto aos aspectos demográficos e BIA na distribuição de volume e no estado nutricional, e a mortalidade em 12 meses de acompanhamento. Métodos: estudo de coorte observacional prospectivo para avaliar pacientes prevalentes em HD com BIA de frequência única. Resultados: avaliamos 82 pacientes, 29% acima de 65 anos. Pacientes idosos apresentaram maior AEC/ACT (0,51 vs. 0,44; p < 0,0001), e ângulo de fase mais estreito (PhA) (4,9 vs. 6,4º; p < 0,0001). Quinze pacientes (18,2%) foram a óbito durante acompanhamento, oito (53%) eram idosos. Óbito foi associado à idade (62,6 vs. 50,2 anos, p = 0,012), PhA pós-HD (4,8 vs. 6,2º; p = 0,0001), e AEC/ACT pós-HD (0,50 vs. 0,45, p = 0,015). A análise da curva ROC para prever mortalidade constatou que AEC/ACT ≥ 0,47 e PhA ≤ 5,5º apresentam melhor sensibilidade e especificidade. Sobrevida do paciente em um ano foi menor com AEC/ACT pós-HD ≥ 0,47 (69,5% vs. 90,6%; p = 0,019), idade ≥ 65 anos (64,2% vs. 86,2%; p = 0,029), e PhA ≤ 5,5º (68,2 vs. 91,0%; p = 0,002). A análise de regressão de Cox demonstrou que PhA [HR 5,04 (IC 95% 1,60–15,86); p = 0,006] permaneceu associado ao óbito após ajuste para idade e AEC/ACT. Conclusão: BIA é útil ao avaliar distribuição de volume e nutrição em pacientes em HD, e juntamente com julgamento clínico, pode ajudar a determinar o peso seco, principalmente em pacientes idosos. PhA mais estreito e maior AEC/ACT pós-HD foram associados a pior sobrevida em um ano.

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“…Bioimpedance analysis (BIA) is an important and non-invasive method to evaluate body composition, and has been validated in different populations, including dialysis patients [6][7][8][9][10] . BIA and phase angle (PhA) measurements provide information on volume distribution and nutritional status, improving evaluation on malnourishment, frailty and sarcopenia [11][12][13] .…”

Section: Introductionmentioning

confidence: 99%

Bioimpedanciometry in nutritional and hydration assessments in a single dialysis center

et al. 2023

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Background: Bioimpedance analysis (BIA) has been demonstrated to add accuracy to nutritional and volume status assessments in dialysis (HD) patients. Aim: to describe a sample of dialysis patients from a single center on their demographics and BIA of volume distribution and nutritional status, and mortality during 12-month follow-up. Methods: prospective observational cohort study to evaluate vintage HD patients with single-frequency BIA. Results: we evaluated 82 patients, 29% over 65 years old. Elderly patients had higher ECW/TBW (0.51 vs. 0.44, p < 0.0001), and narrower phase angle (PhA) (4.9 vs. 6.4º, p < 0.0001). Fifteen patients (18.2%) died during follow-up, eight (53%) were elderly. Death was associated with age (62.6 vs. 50.2 years, p = 0.012), post-HD PhA (4.8 vs. 6.2º, p = 0.0001), and post-HD ECW/TBW (0.50 vs. 0.45, p = 0.015). The ROC curve analysis to predict mortality found ECW/TBW ≥ 0.47 and PhA ≤ 5.5º to have the best sensitivity and specificity. One-year patient survival was lower with post-HD ECW/TBW ≥ 0.47 (69.5% vs. 90.6%, p = 0.019), age ≥ 65 years (64.2%, vs. 86.2%, p = 0.029), and PhA ≤ 5.5º (68.2 vs. 91.0%, p = 0.002). Cox regression analysis demonstrated that PhA [HR 5.04 (95%CI 1.60–15.86), p = 0.006] remained associated with death after adjusting for age and ECW/TBW. Conclusion: BIA is useful in assessing volume distribution and nutrition in HD patients, and combined with clinical judgement, may help determine dry weight, especially in elderly patients. Narrower PhA and higher ECW/TBW after HD were associated with poorer one-year survival.

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Effect of Change in Fluid Status Evaluated by Bioimpedance Techniques on Body Composition in Hemodialysis Patients

Cited by 9 publications

References 35 publications

Value of quantitative ultrasound and bioelectrical impedance analysis in detecting low bone mineral density in hemodialysis

Value of quantitative ultrasound and bioelectrical impedance analysis in detecting low bone mineral density in hemodialysis

Bioimpedanciometria em avaliações nutricionais e de hidratação em um único centro de diálise

Bioimpedanciometry in nutritional and hydration assessments in a single dialysis center

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