Abstract: SA-PO069

Extracellular and Cardiothoracic Hypervolemia Evaluated with Bioimpedance Analysis as a Prognostic Marker in AKI

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Lavilla, Francisco javier, Clinica Universidad de Navarra, Pamplona, Spain
  • Errasti, Pedro, Clinica Universidad de Navarra, Pamplona, Spain
  • Alfaro Sanchez, Christian Israel, Clinica Universidad de Navarra, Pamplona, Spain
  • Garcia-Fernandez, Nuria, Clinica Universidad de Navarra, Pamplona, Spain
  • Fdez-Felechosa, Pelayo Moiron, Clinica Universidad de Navarra, Pamplona, Spain
  • Mora gutierrez, Jose maria, Clinica Universidad de Navarra, Pamplona, Spain
Background

The bioelectrical impedance analysis (BIA) can offer information about volemia. We evaluate corporal, hemodynamic BIA, and volemic parameters (Extracelular/intracelular watter ratio –ECW/ICW- , Extracelular/Total body watter ratio –ECW/TBW-, and Fluid thoracic volumen –FTV-) in acute kidney injury (AKI).

Methods

We include a cohort of 159 patients (médium age 66 years SD 1.3, and male 73 %) with AKI and corporal BIA (Study A), and another cohort of 50 patients (mean age 71.2 years SD 1.6, 79.6% males) with AKI and hemodynamic BIA (Study B) . We evaluate clinical prognostic index (individual severity index –ISI-), analytical inflammatory parameter (C-reactive protein) and chronic health index (Karnofsky –K-). We evaluate mortality and renal replacement therapy requeriment. We use SPSS 20.0.

Results

Study A: Exitus 27%. ECW/ICW and ECW/TBW was associated with prognosis index, clinical and analytical parametes in AKI.
ECW/ICW was associated with ISI (r=-0.240, p=0.002) and CRP (r=0.224, p=0.006) and Karnosky(r=-0.253 p<0.002). ECW/TBW was associated with ISI (r=-0.115 p=0.148) and CRP (r=0.116 p=0.158 ) and Karnosky(r=-0.242 p=0.002).
ECW/ICW was associated with risk mortality (OR 2.313 p=0.004 CI 95% 1.308-4.092), and ECW/TBW also (OR 5.539 p=0.018 CI 95% 1.333-23.007) . The AUC with ECW/ICW was 0.773 (p=0.001, CI 95% 0.672- 0.874) and with ECW/TBW was 0.734 (p=0.003, CI 95% 0.625- 0.844) respect to survive.
Extracelular corporal volumen not was associated with renal replacement therapy requeriment.
Study B: Renal replacement therapy was associated with higher FVT (p= 0.005 37/49.2 l/kOhm), and ventilatory support also (p=0.005 37 vs 49.2 l/kOhm). FVT was associated with C reactive protein (r=-0.310, p= 0.046). FVT not was associated with mortality.

Conclusion

Higher ECW/ICW or ECW/TBW are associated with poor prognosis in AKI. Extracelular hypervolemia are related with inflammatory, proteín metabolism, and health status prior to the event. Thoracic hypervolemia was associated with respiratory failure and renal replacement therapy requeriment. Both BIAs can used to made a better AKI patient management (use of diuretic, intravenous solutions) and triage (mortality, respiratory failure with renal replacement theraphy risk).