Abstract: TH-PO0884
Extracellular Fluid (ECF) Estimation in Patients with CKD Stage 5 on Maintenance Haemodialysis (CKD-5D) by Various Methods
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
- Jhajhria, Anil Kumar, Rama Medical College Hospital and Research Centre Hapur, Hapur, UP, India
- Dassi, Manisha, Max Super Speciality Hospital, Ghaziabad, Uttar Pradesh, India
- Chugh, Nishkarsh, Rama Medical College Hospital and Research Centre Hapur, Hapur, UP, India
- Choudhary, Shipra, Yashoda Super Speciality Hospital, Kaushambi, UP, India
- Jha, Prem Mohan, Max Super Speciality Hospital, Ghaziabad, Uttar Pradesh, India
Background
The aim of this study was to estimate ECF status in CKD-5D patietns by clinical examination, Ultrasound (measuring lung comet scores/ULCs, inferior vena cava diameters/ IVCD and Inferior Vena Cava Collapsibility index /IVCCI) & biochemical methods (brain natriureteric peptide/BNP) and to compare them with bioimpedance spectroscopy/ BIS (gold standard) and to assess the effectiveness of these methods in detecting the changes in fluid status after ultrafiltration.
Methods
We evaluated 65 CKD-5D patients. Bedside evaluation was done pre-HD and 30 minutes post-HD by clinical examination, multifrequency BIS, ultrasound [ ULCs, IVCD(max), IVCD(min), IVCCI ]. BNP levels were measured before & 30 minutes post-HD.
Results
The Mean value for ECF measurement (pre-HD) was 3400 ml for Body Composition Monitor estimates. While values for other measures pre-HD were as 18.96mm for IVCD Max, 13.35mm for IVCD Min, 30.30 % for IVCCI, 16.42 for ULC Score in numbers and 411.71 pg/ml for BNP. After these measeurements for fluid status by various techniques a correlation was sought. Correlation with BCM was only 0.167 for BNP. While it was 0.586 ( p value <0.01) with ULC score, 0.544( p value <0.01) with IVCD min, 0.682( p value <0.01) with IVCD max and -0.323(p value <0.01) with IVCC. After baseline estimation all patients underwent HD. Again ECF measurement with all these parameters was done. A comparison between pre & post HD values showed that all parameters declined significantly after fluid removal. Post HD analysis for Significant correlation with BCM was 0.793(p value <0.01) with ULC score, 0.558(p value <0.01) with IVCD min, 0.462(p value <0.01) with IVCD max and -0.521(p value <0.01) with IVCC while correlation with BNP was insignificant (r = -0.004). The correlations with BCM were significant only for IVCC, IVCD Max, IVCD Min and ULCs. A significant correlation of fluid removed was observed with BIS (p<0.05) and ULC(p<0.01) only.
Conclusion
Bioimpedence Spectroscopy is simple, bedside, safe, convenient, reproducible & objective method of ECF status estimation in CKD-5D patients. Other measures such as ultrasonographic methods like IVC diameters & IVC collapsibility index correlates well with standard bio impedance spectroscopy & can be used for better assessment of ECF status in CKD-5D patients. Clinical examination & BNP may not be a reliable method for same.