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Kidney Week

Abstract: FR-PO889

Effect of Bioelectrical Impedance Analysis-Guided Comparing with Standard Clinical-Guided Dry Weight Assessment on Sleep Quality in Chronic Hemodialysis Patients

Session Information

Category: Dialysis

  • 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular


  • Sethakarun, Sethanant, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Phanachet, Pariya, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Kitiyakara, Chagriya, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Reutrakul, Sirimon, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Nongnuch, Arkom, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Sleep disturbances are common among chronic hemodialysis patients, leading to poor quality of life, increased morbidity and mortality. Hypervolemia has been linked to sleep problems in chronic hemodialysis patients, thus optimizing fluid status might improve sleep quality in such patients. This study aim to compare subjective and objectively measured sleep parameters, using Pittsburgh Sleep Quality Index (PSQI) questionnaire and actigraphy recordings, between bioelectrical impedance analysis (BIA)-guided and standard clinical-guided dry weight assessment during 6 months period.


We randomly assigned 19 chronic hemodialysis patients with subclinical hypervolemia; defined as clinically euvolemic status despite the ratio of extracellular water to total body water more than 0.4 on BIA, who were poor sleeper (PSQI>5) to either BIA-guided (BIA group) or standard clinical-guided dry weight group (clinical group). The outcomes were changes in PSQI score, and sleep parameters by actigraphy at 1, 3 and 6 months.


Mean age was 63.53 ± 11.12 years and 42.11% were male. The baseline characteristic and sleep quality were comparable. At 3 and 6 months, subjective sleep quality in the BIA group significantly improved as reflected by a greater decline in PSQI score compared to the clinical group [3 months: mean difference -1.8 (-2.98 to -0.63), p= 0.003; 6 months: mean difference -3.11 (-4.31 to -1.92), p<0.01](figure 1). However, sleep parameters by actigraphy were not significantly different between groups.


Better optimization of fluid status using BIA significantly improves subjective sleep quality in chronic hemodialysis patients. This should be further explored in larger clinical trial.

Figure 1. Change in PSQI score during study period.


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