Abstract: SA-PO769

Effect of Fluid Status on the Fat Mass Estimated by Bioimpedance in Hemodialysis Patients

Session Information

Category: Dialysis

  • 601 Standard Hemodialysis for ESRD

Authors

  • Abbas, Samer R., Renal Research Institute, New York, New York, United States
  • Thijssen, Stephan, Renal Research Institute, New York, New York, United States
  • Penne, Erik Lars, Medical Center Alkmaar, Alkmaar, Netherlands
  • Raimann, Jochen G., Renal Research Institute, New York, New York, United States
  • Levin, Nathan W., None, New York, New York, United States
  • Kotanko, Peter, Renal Research Institute, New York, New York, United States
  • Zhu, Fansan, Renal Research Institute, New York, New York, United States
Background

This prospective study utilizes calf bioimpedance spectroscopy (cBIS) to guide the attainment of dry weight (DWcBIS) in chronic hemodialysis (HD) patients. In the present research we evaluate whether fat mass is altered when DWcBIS is attained.

Methods

Target post-HD weight was gradually reduced from baseline (BL) until DWcBIS was achieved. DWcBIS was defined as the presence of both flattening of the curve of extracellular resistance during HD and the attainment calf normalized resistivity (CNR) in the normal range (Zhu, Physiol Mea 2008). Extracellular (ECV), intracellular (ICV) volume and total body water (TBW) were measured using whole body bioimpedance spectroscopy (Hydra 4200). Fluid overload (FO), lean body mass (LBM), and fat mass (FM) were calculated according to a body composition model (Chamney, Am J Clin Nutr 2007).

Results

Twenty-eight patients (13 females; 7 diabetic; age 53.7±12 years) achieved DWcBIS over a period of 43.8±30.1 days. On average 16±10 measurements per patient were required to attain DWcBIS. Although significant decreases in body weight, CNR and ECV pre and post HD were observed, LBM and FM at DWcBIS did not differ significantly from BL (Table 1). ECV/TBW and FO were non-significantly higher at BL compared to DWcBIS (Table 1).

Conclusion

This study showed that attainment of DWcBIS did not affect fat mass.

Table 1
 Wt (kg)CNRECV (L)ECV/TBWFO (kg)LBM (kg)Fat (kg)
Pre HD
BL
78±15.814.2±216.9±2.60.48±0.051.8±3.234.7±15.531.2±16.3
DWcBIS76±15.716.2±2.116.0±2.70.47±0.041.7±2.335.5±9.428.8±12.5
p value<0.0001<0.0001<0.0010.20.077 0.230.79
Post HD
BL
75.4±15.617.9±2.514.4±2.20.43±0.05   
Post HD
DWcBIS
73.5±15.620.5±2.413.7±2.20.42±0.05   
p value<0.0001<0.0001<0.0010.1