Abstract: FR-PO0399
Impact of Fluid Overload on Body Composition and Nutritional Status in Patients on Hemodialysis: Insights from a Prospective Study
Session Information
- Dialysis: Measuring and Managing Symptoms and Syndromes
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Kim, Do Hyoung, Hallym University Kangnam Sacred Heart Hospital, Yeongdeungpo-gu, Seoul, Korea (the Republic of)
- Oh, Dong-jin, Myongji Hospital, Goyang-si, Gyeonggi-do, Korea (the Republic of)
Background
Maintaining optimal fluid balance and nutritional status is essential in hemodialysis (HD) patients, as overhydration (OH) is an independent predictor of adverse outcomes. This study aimed to evaluate the association between fluid overload and body composition indices, and to determine whether fluid status impacts nutritional integrity over time.
Methods
We conducted a prospective cohort study involving 107 maintenance HD patients (age >20 years, dialysis vintage >6 months). Body composition was assessed using a body composition monitor (BCM) at baseline, 12, 24, and 36 months. Key parameters included lean tissue index (LTI), fat tissue index (FTI), body mass index (BMI), phase angle (PhA), and OH. Clinical and biochemical data were collected concurrently. Multivariable linear regression was performed to adjust for confounding variables such as age, sex, serum albumin, and high-sensitivity C-reactive protein.
Results
The mean age was 64.0±11.9 years, and 54.2% were male. Patients were stratified into low and high OH groups based on the mean OH rate. The mean OH rate was 9.1±4.3% in the low OH group and 20.3±3.8% in the high OH group (p<0.001). The proportion of patients with >10% weight loss was significantly higher in the high OH group (20.4% vs. 3.8%, p=0.008). The low OH group had significantly higher values in PhA (4.95±0.89 vs. 3.76±0.73, p<0.001), BMI (24.7±4.2 vs. 23.2±3.3, p<0.001), LTI (14.7±3.2 vs. 12.7±3.0, p=0.001), and body cell mass index (8.32±2.25 vs. 6.89±2.09, p<0.001). A significant negative correlation was observed between OH and LTI (r=–0.27, p=0.006). In multivariable analysis, LTI was negatively associated with FTI (β=–0.285, p<0.001) and OH (β=–0.114, p<0.001).
Conclusion
In HD patients with higher OH, weight loss was more frequent, while PhA, BMI, LTI, and BCMI were significantly lower. LTI was independently and negatively associated with FTI and OH. Routine BCM assessment may help identify high-risk patients and guide individualized nutritional and fluid management to improve outcomes.