Kidney Week

Abstract: TH-PO184

Calculation of Extracellular Fluid Volume from Regular Blood Test Results of Patients Undergoing Hemodialysis

Session Information

• Hemodialysis and Frequent Dialysis - I
  November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Nakai, Shigeru, Fujita Health University School of Health Scieneces, Toyoake, Aichi, Japan

Shigeru Nakai,

• Shibata, Kazuhiko, Yokohama Minami Clinic, Yokohama, Japan

Kazuhiko Shibata,

• Masakane, Ikuto, Honcho-Yabuki Clinic, Yamagata, Japan

Ikuto Masakane,

• Ito, Takahito, Kataguilli Medical Center, Shibata, Japan

Takahito Ito,

• Matsuoka, Teppei, taiseikai medical corporation, ogaki-city Gifu pref., Japan

Teppei Matsuoka,

• Aoki, Takeshi, Nagoya Municipal Industrial Research Institute, Iwakura-shi, Aichi-ken, Japan

Takeshi Aoki,

• Shinzato, Takahiro, Daiko Medical Engineering Research Institute, Nagoya-shi,, Japan

Takahiro Shinzato,

• Hayashi, Hiroki, Fujita Health University School of Medicine, Aichi, Japan

Hiroki Hayashi,

• Tsuboi, Naotake, Fujita Health University School of Medicine, Aichi, Japan

Naotake Tsuboi,

• Hasegawa, Midori, Fujita Health University School of Medicine, Aichi, Japan

Midori Hasegawa,

• Inaguma, Daijo, Fujita Health University School of Medicine, Aichi, Japan

Daijo Inaguma,

• Yuzawa, Yukio, Fujita Health University School of Medicine, Aichi, Japan

Yukio Yuzawa,

• Ookawara, Susumu, Saitama Medical Center, Jichi Medical University, Saitama-city, Japan

Susumu Ookawara,

Background

Uric acid (UA) is a solute that cannot cross cell membranes in the general tissues via simple diffusion, facilitated diffusion, or active transport, indicating that the UA distribution volume (UDiV) is equal to the extracellular fluid volume (ECFV). At ASN 2018, we reported that UDiV is closely correlated with ECFV predicted using the bioimpedance method (BIA-ECFV); however, whether UDiV is a useful tool for distinguishing different hydration statuses remains unclear.

Methods

We compared UDiV calculated from regular blood test results with BIA-ECFV of 53 patients undergoing hemodialysis (HD) predicted using BCM (Fresenius Medical Care). Further, we compared UDiV normalized with the post-HD body weight (nUDiV) in nine patients with pedal edema (overhydrated patients), five with intradialytic hypotension (underhydrated patients), and 24 without any clinical symptoms relating to hydration status (symptom-free patients).

Results

We observed a significant correlation between UDiV (x) and BIA-ECFV (y) (y = 0.69x + 3.25; r-square = 0.61; p < 0.0001). The regression line substantially coincided with the line of identity. Bland-Altman analysis showed a systematic error for UDiV versus BIA-ECFV. In addition, we found a significant difference between UDiV and BIA-ECFV (mean difference = 0.94 L; 95% CI = 0.37-1.52 L). As shown in the figure, the nUDiV could help distinguish different hydration statuses.

Conclusion

UDiV is a plausible alternative marker of BIA-ECFV for the assessment of the hydration statuses of HD patients.

nUDiV and hydration statuses