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Abstract: SA-PO346

Bio-Impedance-Guided Target Weight Correction Improves Fluid Overload in Hemodialysis Patients: A Feasibility Study

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Braam, Branko, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
  • de Ruiter, Anna, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
  • Ukrainetz, Judy A., University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada

Fluid overload in hemodialysis (HD) patients is highly prevalent and is associated with adverse cardiovascular outcomes. The hypothesis of this study was to implement a target weight correction protocol overseen by nursing staff in a hemodialysis unit to reduce fluid overload. This was successfully tested in a feasibility study. Arterial stiffness was measured in response to the intervention.


Of the 16 patients included in the study, 10 were subjected to the intervention (in center 1) and 6 served as time controls (in center 2). Time-average fluid overload (TAFO = pre-dialysis fluid overload – ½ of the one-week averaged interdialytic weight gain) was used as fluid overload parameter. Fluid status was assessed at baseline and then monthly for 2 months before the start of mid-week dialysis run using multi-frequency bioimpedance (Body Composition Monitor, BCM, Fresenius Medical Care) and arterial stiffness using (Arteriograph24TM, Budapest, Hungary). In the intervention group, target weight was adjusted every two weeks based on the BCM measurements. No adjustment of target weight was performed in the control group and the treatment team was blinded from the results.


At baseline, groups were comparable. After two months, TAFO had significantly decreased in the intervention group by 40% from 2.8+1.2 to 1.6+1.2 L (P <0.012), no change was seen in the control group (2.9+1.4 to 2.5+2.0 L, NS). With that, traditional pre-dialysis fluid overload decreased from 3.8+1.2 to 2.7+1.2 L (P <0.009) in the intervention group and no change was observed in the control group (3.6+1.3 to 3.6+2.2L, NS). Blood pressure after two months did not significantly differ in both groups (P>0.05). Arterial stiffness (PWV and AiX) remained unchanged in both groups.


This feasibility study clearly demonstrates that fluid management using a target weight correction protocol based on TAFO assessed by BCM measurements can improve fluid status in HD patients. It did not coincide in this short study with changes in arterial stiffness.