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Abstract: PO1057

Association Between Pulse Pressure and Extracellular to Intracellular Water Ration in Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Ekart, Robert, University Medical Center Maribor, Maribor, Slovenia
  • Keber, Gasper, Medical Faculty University of Maribor, Maribor, Slovenia
  • Knehtl, Masa, University Medical Center Maribor, Maribor, Slovenia
  • Jakopin, Eva, University Medical Center Maribor, Maribor, Slovenia
  • Dvoršak, Benjamin, University Medical Center Maribor, Maribor, Slovenia
  • Hojs, Radovan, University Medical Center Maribor, Maribor, Slovenia
Background

Optimal fluid management is a challenge in patients with end-stage kidney disease (ESRD) on maintenance hemodialysis (HD). Multifrequency bioimpedance spectroscopy (MBIS) is a non-invasive method to estimate body composition, including estimates of extracellular water (ECW) and intracellular water (ICW) and the ratio between both spaces (ECW/ICW). Pulse pressure is a significant risk factor of cardiovascular disease and death in general and dialysis population. Our study aimed to analyse the correlation between systolic, diastolic and pulse pressure with body composition status in ESRD patients before HD.

Methods

We performed a retrospective single-centre cohort study in 93 HD patients. The body composition was measured using the portable whole-body MBIS device, Body Composition Monitor-BCM(®) (Fresenius Medical Care, Bad Homburg, Germany). Blood pressure was measured with OMRON monitors.

Results

The mean age of patients was 64 ± 13 years, mean dialysis vintage 63 (1-352) months, 61% were men, all patients had arteriovenous fistula as vascular access. Sixty-nine (74.2%) patients were fluid overload (FO) with > 1.1 L overhydration. Other data are presented in table 1. We found a statistically significant correlation between the pulse pressure and ECW/ICW ratio (r=0.258; P=0.033) in FO patients. In contrast, there was no significant correlation between systolic, diastolic blood pressure and ECW/ICW ratio in FO patients.

Conclusion

Only pulse pressure and not systolic or diastolic blood pressure values measured before HD are associated with ECW/ICW ratio in FO patients.

Descriptive data of the patients included in the study (N=93)
VariableAll patients (N=93)
Mean ± SD
Fluid overload patients (N=69)
Mean ± SD
NOT fluid overload patients (N=24)
Mean ± SD
P value
Age (years)64.3 ± 1364.3 ± 1364.1 ± 120.943
Dialysis vintage (months)63.2 ± 6465.8 ± 6855.8 ± 490.509
Systolic blood pressure (mmHg)151 ± 21151 ± 22149 ± 190.708
Diastolic blood pressure (mmHg)78 ± 1379 ± 1375 ± 120.168
Pulse pressure (mmHg)73 ± 2172 ± 2275 ± 210.654
MBIS: Extracellular water (ECW) (L)18.1 ± 4.219.03 ± 4.215.4 ± 3.1<0.0001
MBIS: Intracellular water (ICW) (L)18.8 ± 4.419 ± 4.518.3 ± 4.40.527
MBIS: ECW/ICW 0.97 ± 0.141.01 ± 0.130.84 ± 0.1<0.0001
MBIS: Overhydration (L)2.14 ± 1.92.83 ± 1.60.16 ± 1<0.0001

MBIS= multifrequency bioimpedance spectroscopy; HD=hemodialysis