The role of bioelectrical impedance analysis, NT-ProBNP and inferior vena cava sonography in the assessment of body fluid volume in children with nephrotic syndrome

Nalçacıoğlu, Hülya; Özkaya, Ozan; Baysal, Kemal; Kafali, Hassan Candas; Avcı, Bahattin; Tekcan, Demet; Genç, Gürkan

doi:10.1016/j.nefro.2017.04.003

Cited by 9 publications

(9 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the present study, BIS clearly indicated a higher ECW in the ANS patients compared to both the controls (HC group) and patients at remission (NSR group). Importantly, these findings accord with observations made in previous studies in NS patients [4, 25], where absolute fluid volumes were estimated using predictive methods.…”

Section: Discussionsupporting

confidence: 91%

“…BIS has recently been used to demonstrate increased volumes of extracellular water (ECW) in NS patients compared to controls [4]. As well as being able to provide information about the volume of the different body water compartments, BIS also estimates cell membrane capacitance (C M ), which has been suggested as the parameter directly linked to the cell membrane function [5]; low C M has been linked to disease in children [6].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Bioimpedance Resistance Indices and Cell Membrane Capacitance Used to Assess Disease Status and Cell Membrane Integrity in Children with Nephrotic Syndrome

Brantlov

Jødal

Andersen

et al. 2019

The Scientific World Journal

View full text Add to dashboard Cite

Background. Accumulation of extracellular water (ECW) is a major clinical manifestation of nephrotic syndrome (NS) in children. Bioimpedance spectroscopy (BIS) is a simple, noninvasive technique that reflects body water volumes. BIS can further measure cell membrane capacitance (CM), which may be altered in NS. The aims of the study were to explore how BIS measurements could reflect disease status in NS, while avoiding prediction equations which are often only validated in adult populations. Methods. The study involved 8 children (2-10 years) with active NS (ANS group), 5 of which were also studied at NS remission (NSR group), as well as 38 healthy children of similar age (HC group). BIS measurements determined resistances RINF, RE, and RI (reflecting total body water, extracellular water, and intracellular water) and CM. Also resistance indices based on height (H) were considered, RI = H2/R. Results. It was found that RE and RINF were significantly lower in the ANS group than in both NSR and HC groups (p < 0.001). Corresponding resistance indices were significantly higher in the ANS group than in the NSR (p < 0.01) and the HC (p < 0.05) groups, in accordance with elevated water volumes in NS patients. Indices of intracellular water were not significantly different between groups. CM was significantly lower in the ANS group than in NSR and HC groups (p < 0.05). Conclusion. BIS could distinguish children with active NS from well-treated and healthy children. Studies with more children are warranted.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Bioimpedance Resistance Indices and Cell Membrane Capacitance Used to Assess Disease Status and Cell Membrane Integrity in Children with Nephrotic Syndrome

Brantlov

Jødal

Andersen

et al. 2019

The Scientific World Journal

View full text Add to dashboard Cite

show abstract

“…Some authors consider multifrequency bioimpedance technology as a promising approach in body water compartment estimation [13,17,25]. In recent years, data obtained by its application in dialyzed children and adolescents and in pediatric nephrotic syndrome have been reported [16,42]. Using multifrequency bioimpedance, we identified that OH, ECW/ICW, and ECW/TBW were increased in the HD and PD groups compared with the control group.…”

Section: Discussionmentioning

confidence: 89%

Is N-terminal pro-brain natriuretic peptide a reliable marker for body fluid status in children with chronic kidney disease?

Nalçacıoğlu

Özkaya

Kafalı

et al. 2020

aoms

Self Cite

View full text Add to dashboard Cite

Introduction: Brain natriuretic peptides, released in response to left ventricular stress, have a strong prognostic value in dialysis patients. However, their role in detecting abnormalities of fluid status is under debate; the relationship between volume status and brain natriuretic peptides (BNPs) differs among various studies. The aim of our study was to evaluate the clinical utility of N-terminal proBNP in the assessment of fluid status and cardiovascular risk in this setting. Material and methods: The study included 65 children: 10 pre-dialysis, 13 hemodialysis, 12 peritoneal dialysis patients and 30 healthy controls. Volume status was determined by multifrequency bioimpedance and NTpro-BNP, as well as echocardiography to estimate the left ventricle structure and function. Results: The median log NT-proBNP values of hemodialysis and peritoneal dialysis patients were 3.66 (2.05-4.90) and 3.57 (2.51-4.13) pg/ml, respectively, and significantly higher compared with the control group (p < 0.001, p < 0.001). On simple correlation, NT-proBNP was correlated with markers of volume overload and cardiac dysfunction. On multivariate regression analysis, only left ventricle mass index (β = 0.402, p = 0.003) and left atrium diameter (β = 0.263, p = 0.018) were independently associated with NT-proBNP (adjusted R 2 of the model: 0.707, p < 0.001). Conclusions: Our research suggested that NT-proBNP, which was correlated with LV systolic and diastolic dysfunction and fluid overload as assessed by bioimpedance, can be used to evaluate cardiovascular states in a chronic kidney disease (CKD) population. From the early stages of CKD, periodic monitoring of NT-proBNP levels may be essential for early detection of patients with high risk of cardiovascular events, and for taking preventive intervention as soon as possible.

show abstract

“…However, data regarding the usage of bioelectrical impedance in nephrotic syndrome is limited. So far, bioimpedance technology has been used to estimate the fluid status of patients with nephrotic syndrome rather than body composition [ 18 – 21 ]. We decided to use this method to compare body composition in different groups of patients with kidney disease as simple tool which can be used at the patients’ bedside.…”

Section: Discussionmentioning

confidence: 99%

Protein energy-wasting associated with nephrotic syndrome – the comparison of metabolic pattern in severe nephrosis to different stages of chronic kidney disease

et al. 2020

View full text Add to dashboard Cite

Background: Nephrotic syndrome (NS) is associated with a hypercatabolic state expressed as an exacerbated degradation of muscle mass. However, the clinical significance of this phenomenon has not yet been investigated. The aim of the study was to evaluate the nutritional status of patients with severe NS (defined as nephrotic range proteinuria with hypoalbuminemia ≤2.5 g/dL) and estimated glomerular filtration rate (eGFR) ≥45 mL/min/1.73 m 2 in comparison to patients in different stages of chronic kidney disease (CKD). Methods: Twenty men with severe NS (NS group) and 40 men without proteinuria similar in term of serum creatinine (control group) were included into the study. A retrospective cohort of 40 men with CKD stage G4 (PreD group) and 20 haemodialysis men (HD group) were added to the analysis after matching for age, height and weight using propensity score matching. The bioimpedance spectroscopy and biochemical nutritional markers were evaluated. Results: Nephrotic patients had a significantly lower lean tissue mass (LTM; p = 0.035) and index (a quotient of LTM over height squared, LTI; p = 0.068), with an expected deficiency of LTM by 3.2 kg, and LTI by 0.9 kg/m 2 when compared to the control group. A significant lean tissue deficit (defined as LTI below the lower limit of the reference range by 1.0 kg/m 2) was observed in 12.5% of patients in the control group in comparison to 31.7% with advanced CKD (PreD+HD; p = 0.032) and 50% with NS (p = 0.003). NS group presented with higher phosphorus (p = 0.029), uric acid (p = 0.002) and blood urea (p = 0.049) than the control group. Blood urea was strongly negatively correlated with LTM in NS (r = − 0.64, p = 0.002). Nine nephrotic patients (45%) were identified as hypercatabolic based on severe hyperphosphatemia (> 5.0 mg/dL) and/or hyperuricemia (> 8.0 mg/dL), and were characterized by higher blood urea and lower prealbumin, as well as LTM lower by 5.6 kg than in less catabolic individuals. Conclusions: In term of lean tissue amount, NS group was more similar to advanced CKD than to the control group. We concluded that specific metabolic pattern with elevated phosphorus, uric acid and blood urea, and lean tissue deficiency may be defined as protein-energy wasting associated with nephrotic syndrome (neph-PEW).

show abstract

The role of bioelectrical impedance analysis, NT-ProBNP and inferior vena cava sonography in the assessment of body fluid volume in children with nephrotic syndrome

Abstract: Our findings support the lack of hypovolaemia in NS during acute attack. In addition, BIA is an easy-to-perform method for use in routine clinical practice to determine hydration status in patients with NS.

Cited by 9 publications

References 37 publications

Bioimpedance Resistance Indices and Cell Membrane Capacitance Used to Assess Disease Status and Cell Membrane Integrity in Children with Nephrotic Syndrome

Bioimpedance Resistance Indices and Cell Membrane Capacitance Used to Assess Disease Status and Cell Membrane Integrity in Children with Nephrotic Syndrome

Is N-terminal pro-brain natriuretic peptide a reliable marker for body fluid status in children with chronic kidney disease?

Protein energy-wasting associated with nephrotic syndrome – the comparison of metabolic pattern in severe nephrosis to different stages of chronic kidney disease

Contact Info

Product

Resources

About