Kidney Week

Abstract: TH-PO0871

Clinical Effect of Bioelectrical Impedance Analysis-Based Dry Weight Assessment on Intradialytic Hypotension Risk in Patients on Hemodialysis

Session Information

• Dialysis: Prescription, Physiology, and Treatment Optimization
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Kim, Jeeyoung, Chung Ang University Hospital, Dongjak-gu, Seoul, Korea (the Republic of)

Jeeyoung Kim, MD

• Song, Yejin, Clinical Research, InBody, Gangnam-gu, Seoul, Korea (the Republic of)

Yejin Song

• Choi, Yunjung, Clinical Research, InBody, Gangnam-gu, Seoul, Korea (the Republic of)

Yunjung Choi

• Kwon, Soie, Chung Ang University Hospital, Dongjak-gu, Seoul, Korea (the Republic of)

Soie Kwon, MD

• Hwang, Jin Ho, Chung Ang University Hospital, Dongjak-gu, Seoul, Korea (the Republic of)

Jin Ho Hwang, MD, PhD

• Shin, Jungho, Chung Ang University Hospital, Dongjak-gu, Seoul, Korea (the Republic of)

Jungho Shin, MD, PhD

Background

Intradialytic hypotension (IDH) is a frequent complication in hemodialysis patients, often linked to inaccurate dry weight (DW) estimation. Although bioelectrical impedance analysis (BIA) enables objective DW assessment, the impact of BIA-clinical DW discrepancy on IDH risk remains unclear.

Methods

Maintenance hemodialysis sessions at Chung-Ang University Hospital (2016–2023) were retrospectively analyzed. Weight deviation defined as post-dialysis weight minus BIA-based DW. IDH was nadir SBP <90 mmHg (pre-dialysis SBP <160 mmHg) or <100 mmHg (≥160 mmHg). Agreement was assessed via Bland–Altman analysis and intraclass correlation coefficient (ICC); IDH associations via logistic regression and generalized estimating equations (GEE).

Results

Of 931 hemodialysis sessions collected from 180 patients, 799 sessions from 156 patients (53.9% male; mean age 69.5±12.1 years) were analyzed. BIA-based DW agreed with clinical DW (ICC=0.993; mean bias −0.41 kg, 95% LoA −3.62 to 2.80 kg). IDH occurred in 80 sessions (10.1%). Lower weight deviation was associated with higher IDH risk: univariable (OR 0.61, 95% CI 0.46–0.80, p<0.001), multivariable (OR 0.65, 95% CI 0.49–0.87, p=0.004), GEE (OR 0.61, 95% CI 0.44–0.84, p=0.002).

Conclusion

Fluid removal exceeding BIA-based DW was independently associated with increased IDH risk. These findings suggest that BIA-based DW assessment may help identify patients at high risk of IDH and support the development of individualized fluid management strategies in hemodialysis.

Agreement between BIA-based and clinically determined dry weight