Whole-body single-frequency bioimpedance analysis in pediatric hemodialysis patients

Oh, Gia; Wong, Cynthia; Begin, Brandy; Salsbery, Kari; Sutherland, Scott M.; Chaudhuri, Abanti

doi:10.1007/s00467-014-2778-7

Cited by 17 publications

(11 citation statements)

References 21 publications

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“…Changes in whole-body impedance at 50 kHz reflect changes in body water volume during dialysis [21]. The reactance component of this measurement (Xc) can help identify dry weight [22] and the change in the resistance component ( R ) with fluid removal correlates with intradialytic hypotension and left ventricular mass index [23]. The variability in blood pressure and heart rate during dialysis can be partially explained by vector analysis [24].…”

Section: Discussionmentioning

confidence: 99%

Validating the use of bioimpedance spectroscopy for assessment of fluid status in children

et al. 2018

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BackgroundBioimpedance spectroscopy (BIS) with a whole-body model to distinguish excess fluid from major body tissue hydration can provide objective assessment of fluid status. BIS is integrated into the Body Composition Monitor (BCM) and is validated in adults, but not children. This study aimed to (1) assess agreement between BCM-measured total body water (TBW) and a gold standard technique in healthy children, (2) compare TBW_BCM with TBW from Urea Kinetic Modelling (UKM) in haemodialysis children and (3) investigate systematic deviation from zero in measured excess fluid in healthy children across paediatric age range.MethodsTBW_BCM and excess fluid was determined from standard wrist-to-ankle BCM measurement. TBW_D2O was determined from deuterium concentration decline in serial urine samples over 5 days in healthy children. UKM was used to measure body water in children receiving haemodialysis. Agreement between methods was analysed using paired t test and Bland-Altman method comparison.ResultsIn 61 healthy children (6–14 years, 32 male), mean TBW_BCM and TBW_D2O were 21.1 ± 5.6 and 20.5 ± 5.8 L respectively. There was good agreement between TBW_BCM and TBW_D2O (R2 = 0.97). In six haemodialysis children (4–13 years, 4 male), 45 concomitant measurements over 8 months showed good TBW_BCM and TBW_UKM agreement (mean difference − 0.4 L, 2SD = ± 3.0 L). In 634 healthy children (2–17 years, 300 male), BCM-measured overhydration was − 0.1 ± 0.7 L (10–90th percentile − 0.8 to + 0.6 L). There was no correlation between age and OH (p = 0.28).ConclusionsThese results suggest BCM can be used in children as young as 2 years to measure normally hydrated weight and assess fluid status.Electronic supplementary materialThe online version of this article (10.1007/s00467-018-3971-x) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Validating the use of bioimpedance spectroscopy for assessment of fluid status in children

et al. 2018

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“…Role of IDWG in HTN is unclear. While some report overhydration as the main cause of HTN, others find that it is frequently not associated with HTN, in both adults and children . Recommendations to decrease dNa are made to improve IDWG by decreasing Na load and thirst .…”

Section: Discussionmentioning

confidence: 99%

“…While some report overhydration as the main cause of HTN, others find that it is frequently not associated with HTN, in both adults and children. 2,8,9,27,[38][39][40][41] Recommendations to decrease dNa are made to improve IDWG by decreasing Na load and thirst. 2,7,42 Aggressive fluid removal used for high IDWG may lead to intradialytic hypotension, with reduction of blood flow to vital organs.…”

Section: Discussionmentioning

confidence: 99%

Effect of the decrease in dialysate sodium in pediatric patients on chronic hemodialysis

Marsenić

Anderson

Couloures

et al. 2015

Hemodialysis International

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Optimal dialysate sodium (dNa) is unknown, with both higher and lower values suggested in adult studies to improve outcomes. Similar studies in pediatric hemodialysis (HD) population are missing. This is the first report of the effect of two constant dNa concentrations in pediatric patients on chronic HD. 480 standard HD sessions and interdialytic periods were studied in 5 patients (age 4-17 years, weight 20.8-66 kg) during a period of 6-11 months per patient. dNa was 140 mEq/L during the first half, and 138 mEq/L during the second half of the study period for each patient. Lowering dNa was associated with improved preHD hypertension, decreased interdialytic weight gain, decreased need for ultrafiltration, lower sodium gradient and was well tolerated despite lack of concordance with predialysis sNa, that was variable. Further studies are needed to verify our findings and to investigate if an even lower dNa may be more beneficial in the pediatric HD population.

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“…This enables intervention during dialysis to maximise fluid removal in the minimum time without complications. When combined with bioimpedance analysis, the clinical assessment of fluid status is enhanced [20, 25]. …”

Section: What Ways Do We Have To Improve the Dialysis Process And Howmentioning

confidence: 99%

Assessment of dialysis adequacy: beyond urea kinetic measurements

Rees

2018

Pediatr Nephrol

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Adequacy of dialysis is a term that has been used for many years based on measurement of small solute clearance using urea and creatinine. This has been shown in some but not all studies in adults to correlate with survival. However, small solute clearance is just one minor part of the effectiveness of dialysis and in fact ‘optimum’ dialysis, rather than ‘adequate’ dialysis is what most paediatric nephrologists would want for their patients. Additional ways to assess the success of dialysis in children would include dialysis access complications and longevity, preservation of residual kidney function, body composition, biochemical and haematological control, nutrition and growth, discomfort during the dialysis process and psychosocial adjustment including hospitalisation and school attendance. These criteria need to be balanced against a dialysis programme that has the least possible adverse effects on quality of life.

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Whole-body single-frequency bioimpedance analysis in pediatric hemodialysis patients

Abstract: Our study showed that %RΔ strongly correlates with %BWΔ and %BVΔ and that %RΔ also correlated with intradialytic symptoms and LVMI.

Cited by 17 publications

References 21 publications

Validating the use of bioimpedance spectroscopy for assessment of fluid status in children

Validating the use of bioimpedance spectroscopy for assessment of fluid status in children

Effect of the decrease in dialysate sodium in pediatric patients on chronic hemodialysis

Assessment of dialysis adequacy: beyond urea kinetic measurements

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