Kidney Week

Abstract: SA-OR071

Bioelectrical Impedance Analysis (BIA) Versus Clinical Criteria for Setting Ultrafiltration (UF) in Chronic Hemodialysis (HD) Patients

Session Information

• Improving Dialysis Delivery and Patient Outcomes
  October 27, 2018 | Location: 2, San Diego Convention Center
  Abstract Time: 05:06 PM - 05:18 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Mora, Jeffrey Pascion, National Kidney and Transplant Institute, Quezon City, Philippines

Jeffrey Pascion Mora, MD

• Danguilan, Romina A., National Kidney and Transplant Institute, Quezon City, Philippines

Romina A. Danguilan,

• Casasola, Concesa, National Kidney and Transplant Institute, Quezon City, Philippines

Concesa Casasola,

Background

This study compared the laboratory, echocardiographic and clinical outcomes of patients where dry weight (DW) was determined using BIA or clinical evaluation, thus guiding UF.

Methods

A prospective randomized study involving chronic stable HD patients, 21 in BIA and 21 in Clinical-group, managed based on a structured protocol to set UF. The effect on volume status and CV indices after 3 months was evaluated. BIA was done fortnightly for BIA-grp while hypo- or hypervolemia was observed every HD session for the other group. CBC, electrolytes were done monthly, inferior vena cava (IVC) size and collapsibility index (CI), Left ventricular (LV) size, cardiac index and ejection fraction were done at baseline and month 3. Intradialytic events were noted.

Results

DW decreased by 1.12 kg in BIA-grp (p=0.012). Lab results were similar in both groups. IVC and LV size decreased by 0.1 cm in BIA-grp but remained unchanged in Clinical-grp, although not significant (p=0.2183, p=1.000). IVC CI significantly increased to 49.5% in BIA-grp but dropped to 40.8% in Clinical-grp (p=0.0186) suggesting a decrease in right atrial (RA) pressure and attainment of euvolemia in the former group. There was a non-significant increase (4%) in the EF in BIA compared to Clinical (2%) group (p=0.527). Significant change in diastolic BP (7 mmHg drop) and MAP (8 mmHg drop) were seen in the BIA-grp (p=0.034, p=0.043). Intradialytic episodes of muscle cramps, chest pain/palpitations, and dizziness occurred only in BIA-grp (p=0.000).

Conclusion

BIA-guided determination of UF resulted in a significantly reduced dry weight, DBP, MAP, and RA pressure in a chronic HD population while other cardiac indices had a tendency to improve. All these may result in improved cardiac function and CV outcomes.

Funding

• Commercial Support –