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Abstract: PO1149

Prevalence of Fluid Overload in a US Dialysis Population

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Moissl, Ulrich, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany
  • Rivera Fuentes, Lemuel, Renal Research Institute, New York, New York, United States
  • Hakim, Mohamad I., Renal Research Institute, New York, New York, United States
  • Rosales, Laura, Renal Research Institute, New York, New York, United States
  • Zhu, Fansan, Renal Research Institute, New York, New York, United States
  • Kothari, Dewangi Ajay, Renal Research Institute, New York, New York, United States
  • Raimann, Jochen G., Renal Research Institute, New York, New York, United States
  • Thijssen, Stephan, Renal Research Institute, New York, New York, United States
  • Kotanko, Peter, Renal Research Institute, New York, New York, United States
Background

Hypervolemia remains one of the main reasons for increased cardiovascular (CV) morbidity and mortality in chronic hemodialysis (HD) patients. Quantification of fluid status using bioimpedance spectroscopy (BIS) has become routine in many countries outside the United States (US). Due to previous unavailability of FDA-cleared BIS devices, no cross-sectional appraisal of fluid status in HD patients has yet been done in the US. The aim of this study was to perform the first assessment of fluid status in a US dialysis population using a BIS device

Methods

Fluid overload (FO) was measured in 170 chronic HD patients from four clinics in New York City using the BCM Body Composition Monitor (Fresenius Medical Care) which provides the amount of excess extracellular water (ECW) in liters. Measurements were performed before dialysis; post-dialysis fluid status was estimated by subtracting the removed fluid from pre-dialysis FO

Results

Pre- and post-dialysis FO were found to be 2.2L ± 2.4 L and -0.2 ± 2.7 L (mean ± SD), respectively. Before the start of HD, 42.9% of patients were fluid overloaded (criterion: FO/ECW > 15% in males, and >13% in females), 53.5 % were normally hydrated, and 3.5% were fluid depleted (FO/ECW <-7%).

Conclusion

The prevalence of pre-HD fluid overload was significantly higher in this US population (42.9%) than in a previously published large European cohort (29.6%). This suggests the need for more adequate assessment of fluid status to support the clinicians in identifying and treating fluid overload in HD patients

Figure 1: a) distribution of pre-dialysis FO in liters, b) relative FO

Funding

  • Private Foundation Support