Overhydration measured by bioimpedance analysis and the survival of patients on maintenance hemodialysis: a single-center study.
10.1016/j.krcp.2015.10.006
- Author:
Ye Jin KIM
1
;
Hong Jae JEON
;
Yoo Hyung KIM
;
Jaewoong JEON
;
Young Rok HAM
;
Sarah CHUNG
;
Dae Eun CHOI
;
Ki Ryang NA
;
Kang Wook LEE
Author Information
1. Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea. kwlee@cnu.ac.kr
- Publication Type:Original Article
- Keywords:
Bioimpedance analysis;
Extracellular water;
Hemodialysis;
Hydration;
Mortality
- MeSH:
Body Composition;
Dialysis;
Follow-Up Studies;
Humans;
Korea;
Mortality;
Renal Dialysis*;
Retrospective Studies;
Serum Albumin;
Survival Rate;
Water
- From:Kidney Research and Clinical Practice
2015;34(4):212-218
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Bioimpedance analysis (BIA) helps measuring the constituents of the body noninvasively. Prior studies suggest that BIA-guided fluid assessment helps to predict survival in dialysis patients. We aimed to evaluate the clinical usefulness of BIA for predicting the survival rate of hemodialysis patients in Korea. METHODS: We conducted a single-center retrospective study. All patients were diagnosed with end-stage renal disorder and started maintenance hemodialysis between June 2009 and April 2014. BIA was performed within the 1st week from the start of hemodialysis. The patients were classified into 2 groups based on volume status measured by the body composition monitor (BCM; Fresenius): an overhydrated group [OG; overhydration/extracellular water (OH/ECW) >15%] and a nonoverhydrated group (NOG; OH/ECW < or =15%). RESULTS: A total of 344 patients met the inclusion criteria. Of these, 252 patients (73.3%) were categorized into the OG and 92 patients (26.7%) into the NOG. Age- and sex-matching patients were selected with a rate of 2:1. Finally, 160 overhydrated patients and 80 nonoverhydrated patients were analyzed. Initial levels of hemoglobin and serum albumin were significantly lower in the OG. During follow-up, 43 patients from the OG and 7 patients from the NOG died (median follow-up duration, 24.0 months). The multivariate-adjusted all-cause mortality was significantly increased in the OG (odds ratio, 2.569; P = 0.033) and older patients (odds ratio, 1.072/y; P < 0.001). No significant difference of all-cause or disease-specific admission rate was observed between the 2 groups. CONCLUSION: The ratio of OH/ECW volume measured with body composition monitor is related to the overall survival of end-stage renal disorder patients who started maintenance hemodialysis.
