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Abstract: FR-PO0113

Evaluating the Effectiveness of Bioelectrical Impedance Analysis in Guiding Ultrafiltration in Hemodialysis and Reducing Complications in Hospitalized Patients with AKI: A Randomized Controlled Study

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Pattharanitima, Pattharawin, Thammasat University Faculty of Medicine, Klong Luang, Pathumthani, Thailand
  • Anumas, Suthiya Anumas, Thammasat University Chulabhorn International College of Medicine, Klong Luang, Pathumthani, Thailand
Background

Effective fluid management is crucial in dialysis, as inaccurate volume assessment can cause complications. Traditional methods are often unreliable, while bioelectrical impedance analysis (BIA) offers a non-invasive, accurate alternative. However, its use in acute kidney injury (AKI) patients is limited. We aimed to assess the effectiveness of BIA in guiding hemodialysis (HD) treatment and reducing complications in hospitalized AKI patients.

Methods

This prospective randomized controlled study, conducted at Thammasat University Hospital (April 2024–February 2025), included 30 patients with AKI assigned to receive BIA-guided or physician-judged fluid management. The primary outcome was intradialytic hypotension (IDH) which is defined by minimum SBP during HD <90 mmHg. Secondary outcomes were cardiac arrhythmia, post-dialysis non-euvolemic status, urine volume at hospital discharge, dialysis-free survival at hospital discharge and in-hospital mortality.

Results

The incidence rate of IDH was significantly lower in the BIA-guided group compared to the physician-judged group (9.9 vs. 23.7 per 100 patient-session), with an incidence rate ratio (IRR) of 0.42 (95% CI 0.18–0.92, p = 0.02). Patients in the BIA-guided group were more likely to achieve euvolemic status than those in the control group, with an IRR for non-euvolemic status of 0.49 (95% CI 0.28–0.85, p = 0.01). No significant differences were observed in other outcomes.

Conclusion

BIA-guided ultrafiltration offers superior fluid management by reducing IDH and achieving greater euvolemic status compared to conventional clinical assessment.

Baseline characteristics

Primary and secondary outcomes

Funding

  • Government Support – Non-U.S.

Digital Object Identifier (DOI)