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Evaluation of Fluid Overload by Bioelectrical Impedance Vectorial Analysis
07:17

Evaluation of Fluid Overload by Bioelectrical Impedance Vectorial Analysis

Published on: August 17, 2022

Towards improved cardiovascular management: the necessity of combining blood pressure and fluid overload

Peter Wabel1, Ulrich Moissl, Paul Chamney

  • 1Research & Development, Fresenius Medical Care D GmbH, Daimlerstrasse 15, D-61352 Bad Homburg, Germany. peter.wabel@fmc-ag.com

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|May 7, 2008
PubMed

Insights

Fluid overload and hypertension vary widely in chronic kidney disease (CKD) patients. A new hydration reference plot (HRP) helps classify patients for better treatment of hypertension and fluid overload.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Biomedical Engineering

Background:

  • Hypertension and fluid overload (FO) are significant issues in chronic kidney disease (CKD).
  • While hypertension prevalence is known, the extent of FO in CKD patients remains unclear.
  • Understanding the interplay between blood pressure and fluid status is crucial for CKD management.

Purpose of the Study:

  • To quantify fluid overload (FO) in hemodialysis patients using a novel bioimpedance spectroscopy device.
  • To analyze the relationship between pre-dialysis systolic blood pressure (BPsys) and hydration status (DeltaHS).
  • To develop a graphical tool (HRP) for classifying patients based on BPsys and DeltaHS for improved treatment strategies.

Main Methods:

  • Utilized a Body Composition Monitor (BCM) for quantitative hydration status assessment (DeltaHS).
  • Analyzed pre-dialysis BPsys and DeltaHS in 500 hemodialysis patients.
  • Developed and applied a hydration reference plot (HRP) comparing patients to a healthy cohort (n=1244).

Main Results:

  • 19% of patients had normal BPsys and DeltaHS.
  • 33% showed reasonable control (BPsys <150 mmHg, DeltaHS <2.5 L).
  • Hypertension with high fluid overload (BPsys >150 mmHg, DeltaHS >2.5 L) occurred in 15% of patients.
  • Hypertension with normal fluid status (BPsys >150 mmHg, DeltaHS <1.1 L) observed in 13%.
  • 10% of patients had low BPsys (<140 mmHg) despite significant fluid overload (DeltaHS >2.5 L).

Conclusions:

  • Significant variability exists in BPsys irrespective of DeltaHS in hemodialysis patients.
  • The HRP is a valuable tool for categorizing patients by BPsys and DeltaHS.
  • This classification aids in selecting objective strategies for managing hypertension and FO in CKD.
Abstract

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