Kidney Res Clin Pract.  2017 Sep;36(3):290-295. 10.23876/j.krcp.2017.36.3.290.

Numerical expression of volume status using the bioimpedance ratio in continuous ambulatory peritoneal dialysis patients: A pilot study

Affiliations
  • 1Division of Nephrology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jwchang@amc.seoul.kr
  • 2Department of Nursing, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 3Division of Nephrology, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea.

Abstract

BACKGROUND
Volume overload results in higher mortality rates in patients on continuous ambulatory peritoneal dialysis (CAPD). The ratio of bioimpedance (RBI) might be a helpful parameter in adjusting dry body weight in CAPD patients. This study examined whether it is possible to distinguish between non-hypervolemic status and hypervolemic status in CAPD patients by using only RBI.
METHODS
RBI was calculated as follows: RBI = impedance at 50 kHz/impedance at 500 kHz. Based on the experts' judgements, a total of 64 CAPD patients were divided into two groups, a non-hypervolemic group and a hypervolemic group. The RBI was measured from right wrist to right ankle (rw-raRBI) by bioimpedance spectroscopy (BCM®, Fresenius Medical Care) before and after the peritosol was emptied. Other RBIs were measured from the right side of the anterior superior iliac spine to the ipsilateral ankle (rasis-raRBI) to control for the electro-physiological effects of peritoneal dialysate.
RESULTS
The mean rw-raRBI of non-hypervolemic patients was higher than that of hypervolemic patients in the presence (1.141 ± 0.022 vs. 1.121 ± 0.021, P < 0.001) of a peritosol. Likewise, the mean rasis-raRBI of non-hypervolemic patients was higher than that of hypervolemic patients (presence of peritosol: 1.136 ± 0.026 vs. 1.109 ± 0.022, P < 0.001; absence of peritosol: 1.131 ± 0.022 vs. 1.107 ± 0.022, P < 0.001).
CONCLUSION
The volume status of CAPD patients was able to be simply expressed by RBI. Therefore, this study suggests that when patients cannot be analyzed using BCM, RBI could be an alternative.

Keyword

Bioimpedance; Hypervolemia; Peritoneal dialysis

MeSH Terms

Ankle
Body Weight
Electric Impedance
Humans
Mortality
Peritoneal Dialysis
Peritoneal Dialysis, Continuous Ambulatory*
Pilot Projects*
Spectrum Analysis
Spine
Wrist
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