Monitoring changes in fluid status with a wireless multisensor monitor: results from the Fluid Removal During...

Body fluid assessment is important for managing chronic kidney disease (CKD) and heart failure (HF). However, accurate detection of fluid retention remains elusive. The Fluid Removal During Adherent Renal Monitoring (FARM) study is a prospective, nonrandomized trial examining the performance of a wireless, noninvasive, multisensor fluid monitoring system, applied to the chest, to determine its performance and reliability during hemodialysis. Patients undergoing regular hemodialysis (n=25) were monitored continuously for 2 consecutive dialysis sessions and the interdialysis period. Physiologic variables, including tissue impedance, were recorded. The volume of fluid removed and weight change during dialysis were measured. An average of 3.4±1.2 L of fluid was removed during dialysis, which was associated with an increase in bioimpedance of 11.3±7.2 Ω. Change in bioimpedance was highly correlated with the amount of fluid removed but less so with weight loss. Normalized bioimpedance change (21.0%±12.1% increase from baseline, P<001) was larger than the normalized weight change (3.6%±1.1%, P<.01), suggesting a higher sensitivity and dynamic range than weight change for detecting fluid removal. The fluid monitoring system accurately tracked fluid and weight loss in patients during hemodialysis, supporting its use as a tool for the management of patient fluid status in disease states.