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Abstract: SA-PO776

Muscle Mass Measured by Multi-Frequency Bioimpedance and Intradialytic Hypotension among Hemodialysis Patients

Session Information

Category: Dialysis

  • 601 Standard Hemodialysis for ESRD

Authors

  • Jeong, Jong Cheol, Ajou University School of Medicine, Suwon, Korea (the Republic of)
  • Choi, YOUNG-IL, Dr.Choi''s Medical Clinc, SEOUL, Korea (the Republic of)
  • Kim, Myoung-sung, Myoung clinic, Ansan, Korea (the Republic of)
  • Lee, MinJeong, Ajou University School of Medicine, Suwon, Korea (the Republic of)
  • Park, Inwhee, Ajou University School of Medicine, Suwon, Korea (the Republic of)
  • Shin, Gyu Tae, Ajou University School of Medicine, Suwon, Korea (the Republic of)
  • Kim, Heungsoo, Ajou University School of Medicine, Suwon, Korea (the Republic of)
Background

With the introduction of bio-impedance devices, more relevant and reproducible assessment have become possible. To find optimal bio-impedance indices to predict clinical outcomes, more data are needed.

Methods

Prevalent hemodialysis patients (duration of dialysis more than 3 months) were enrolled in three dialysis units. At baseline, clinical indices, physical assessment of volume status, arthropometry examination, NT-proBNP and cardiac indicies by chest PA were collected. At follow up, cardiac indices and clinical events including intradialytic hypotension, cardiovascular events, pulmonary edema were collected. Segmental bio-impedance assessments were performed at every assessment.

Results

Total 150 patients were enrolled. Mean age was 58.5 ± 14.1 years old. Female were 75 (50%). Modified Charlson comorbidity score, Tilburg frailty score, and PG-SGA were 3.9 ± 1.8, 3.3 ± 2.3, and 3.2 ± 4.2, respectively. Body mass index was 22.6 ± 3.3 kg/m2.

ECW/TBW was significantly correlated with cardiac index in positive direction. (spearman’s rho 0.351, p < 0.001) ECW/TBW also showed significant correlation with NT-proBNP. (spearman’s rho 0.384, p < 0.001). However, higher ECW/TBW was reported to be associated with intradialytic hypotension in the multivariable logistic regression models. (Odds ratio (OR) 1.627, 95% confidence interval (C.I.) 0.985 – 2.687, p = 0.058) (Figure 1). Skeletal muscle index was negatively associated with ECW/TBW. (spearman’s rho -0.416, p < 0.001) Skeletal muscle index was better predictor for intradialytic hypotension than NT-proBNP (AUC comparison of NT-proBNP vs. skeletal muscle index; 0.721 vs. 0.506, p = 0.003).

Conclusion

Reduced skeletal muscle mass was associated with frequent intradialytic hypotension. Optimal values of ECW/TBW, as other than index as inversed reflection of muscle mass, still need to be validated with clinical outcomes.