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Application of bioimpedance spectroscopy in Asian dialysis patients (ABISAD-III): a randomized controlled trial for clinical outcomes

  • Nephrology - Original Paper
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Abstract

Purpose

Fluid management with body composition monitor based on bioimpedance spectroscopy (BCM-BIS) has been found to be beneficial for dialysis patients. We conducted a study to provide an algorithm for the determination of post-dialysis target weight (PDTW) and to evaluate whether this approach could improve clinical outcomes compared to patients who had PDTW decided clinically.

Methods

Two hundred and ninety-eight dialysis patients participated in this 1-year randomized controlled trial. The outcomes were all-cause hospitalization rate, AFO or CV-related events, hypertension and intra-dialysis morbidities.

Results

80 % of post-dialysis weight reached the target set with current algorithm. All-cause hospitalization rate was not different. Incidence of acute fluid overload (AFO) or CV-related events was lower in study group. Longitudinal data showed decreased incidence of hypertension, intra-dialysis morbidities and intra-dialysis hypotension.

Conclusions

Assessment of PDTW by BCM-BIS with an explicit algorithm decreased AFO or CV-related events, hypertension and intra-dialysis morbidities. Further studies were required to demonstrate possible benefits of hospitalization rate.

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References

  1. Jaeger JQ, Mehta RL (1999) Assessment of dry weight in hemodialysis: an overview. J Am Soc Nephrol 10:392–403

    CAS  PubMed  Google Scholar 

  2. Davenport A (2006) Intradialytic complications during hemodialysis. Hemodial Int 10:162–167

    Article  PubMed  Google Scholar 

  3. Charra B (2007) Fluid balance, dry weight, and blood pressure in dialysis. Hemodial Int 11:21–31

    Article  PubMed  Google Scholar 

  4. Moissl UM, Wabel P, Chamney PW et al (2006) Body fluid volume determination via body composition spectroscopy in health and disease. Physiol Meas 27:921–933

    Article  PubMed  Google Scholar 

  5. Chamney PW, Wabel P, Moissl UM et al (2007) A whole-body model to distinguish excess fluid from hydration of major body tissues. Am J Clin Nutr 85:80–89

    CAS  PubMed  Google Scholar 

  6. Medrano G, Eitner F, Floege J, Leonhardt S (2010) A novel bioimpedance technique to monitor fluid volume state during hemodialysis treatment. ASAIO J 56:215–220

    Article  PubMed  Google Scholar 

  7. Wabel P, Moissl U, Chamney P et al (2008) Towards improved cardiovascular management: the necessity of combining blood pressure and fluid overload. Nephrol Dial Transplant 23:2965–2971

    Article  PubMed  Google Scholar 

  8. Wizemann V, Wabel P, Chamney P et al (2009) The mortality risk of overhydration in hemodialysis patients. Nephrol Dial Transplant 24:1574–1579

    Article  PubMed  PubMed Central  Google Scholar 

  9. Chazot C, Wabel P, Chamney P, Moissl U, Wieskotten S, Wizemann V (2012) Importance of normohydration for the long-term survival of haemodialysis patients. Nephrol Dial Transplant 27:2404–2410

    Article  PubMed  Google Scholar 

  10. O’Lone EL, Visser A, Finney H, Fan SL (2014) Clinical significance of multi-frequency bioimpedance spectroscopy in peritoneal dialysis patients: independent predictor of patient survival. Nephrol Dial Transplant 29:1430–1437

    Article  PubMed  Google Scholar 

  11. Mamat R, Kong NC, Ba’in A et al (2012) Assessment of body fluid status in hemodialysis patients using the body composition monitor measurement technique. J Clin Nurs 21:2879–2885

    Article  PubMed  Google Scholar 

  12. Kuhlmann MK, Zhu F, Seibert E, Levin NW (2005) Bioimpedance, dry weight and blood pressure control: new methods and consequences. Curr Opin Nephrol Hypertens 14:543–549

    Article  PubMed  Google Scholar 

  13. Vujicic B, Mikolasevic I, Racki S, Orlic L, Ljutic D, Bubic I (2013) BCM - Body Composition Monitor: a New Tool for the Assessment of Volume-Dependent Hypertension in Patients on Maintenance Haemodialysis. Coll Antropol 37:815–819

    PubMed  Google Scholar 

  14. Machek P, Jirka T, Moissl U, Chamney P, Wabel P (2010) Guided optimization of fluid status in hemodialysis patients. Nephrol Dial Transplant 25:538–544

    Article  PubMed  Google Scholar 

  15. Moissl U, Arias-Guillen M, Wabel P et al (2013) Bioimpedance-Guided Fluid Management in Hemodialysis Patients. Clin J Am Soc Nephrol 8:1575–1582

    Article  PubMed  PubMed Central  Google Scholar 

  16. Onofriescu M, Hogas S, Voroneanu L et al (2014) Bioimpedance-guided fluid management in maintenance hemodialysis: a pilot randomized controlled trial. Am J Kidney Dis 64:111–118

    Article  PubMed  Google Scholar 

  17. Hur E, Usta M, Toz H et al (2013) Effect of Fluid Management Guided by Bioimpedance Spectroscopy on Cardiovascular Parameters in Hemodialysis Patients: a Randomized Controlled Trial. Am J Kidney Dis 61:957–965

    Article  PubMed  Google Scholar 

  18. Chen HS, Lee KC, Cheng CT et al (2013) Application of Bioimpedance Spectroscopy in Asian Dialysis Patients (ABISAD): serial follow-up and dry weight evaluation. Clin Kidney J 6:29–34

    Article  Google Scholar 

  19. Woods HF (2014) 2013 Annual Medical Director’s Report for Dialysis Centers of NephroCare Asia Pacific. Report presented at NephroCare Taiwan Combined Meeting 2014; May 15, 2014; Taipei, Taiwan

  20. Reddan DN, Szczech LA, Hasselblad V et al (2005) Intradialytic Blood Volume Monitoring in Ambulatory Hemodialysis Patients: a Randomized Trial. J Am Soc Nephrol 16:2162–2169

    Article  PubMed  Google Scholar 

  21. Wieskotten S, Heinke S, Wabel P et al (2007) Modell-basierte Erkennung vonMangelern¨ ahrungmittels Bioimpedanzspektroskopie. Automa- tisierungstechnik 10:531–538

    Google Scholar 

  22. Fotheringham J, Fogarty DG, El Nahas M, Campbell MJ, Farrington K (2015) The mortality and hospitalization rates associated with the long interdialytic gap in thrice-weekly hemodialysis patients. Kidney Int. doi:10.1038/ki.2015.141

    PubMed  Google Scholar 

  23. Tsai YC, Chiu YW, Tsai JC et al (2015) Association of fluid overload with cardiovascular morbidity and all-cause mortality in stages 4 and 5 CKD. Clin J Am Soc Nephrol 10:39–46

    Article  CAS  PubMed  Google Scholar 

  24. Grundy SM, Benjamin IJ, Burke GL et al (1999) Diabetes and cardiovascular disease: a statement for healthcare professionals from the American Heart Association. Circulation 100:1134–1146

    Article  CAS  PubMed  Google Scholar 

  25. Grundy SM (2006) Metabolic syndrome: connecting and reconciling cardiovascular and diabetes worlds. J Am Coll Cardiol 47:1093–1100

    Article  CAS  PubMed  Google Scholar 

  26. West NA, Hamman RF, Mayer-Davis EJ et al (2009) Cardiovascular risk factors among youth with and without type 2 diabetes: differences and possible mechanisms. Diabetes Care 32:175–180

    Article  PubMed  PubMed Central  Google Scholar 

  27. Ozkahya M, Ok E, Cirit M et al (1998) Regression of left ventricular hypertrophy in haemodialysis patients by ultrafiltration and reduced salt intake without antihypertensive drugs. Nephrol Dial Transplant 13:1489–1493

    Article  CAS  PubMed  Google Scholar 

  28. Ozkahya M, Toz H, Ozerkan F et al (2002) Impact of volume control on left ventricular hypertrophy in dialysis patients. J Nephrol 15:655–660

    PubMed  Google Scholar 

  29. Ozkahya M, Ok E, Toz H et al (2006) Long-term survival rates in haemodialysis patients treated with strict volume control. Nephrol Dial Transplant 21:3506–3513

    Article  PubMed  Google Scholar 

  30. Agarwal R, Alborzi P, Satyan S, Light RP (2009) Dry-Weight Reduction in Hypertensive Hemodialysis Patients (DRIP): a randomized, controlled trial. Hypertension 53:500–507

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Van de Kerkhof J, Hermans M, Beerenhout C, Konings C, Van der Sande FM, Kooman JP (2004) Reference values for multifrequency bioimpedance analysis in dialysis patients. Blood Purif 22:301–306

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Special thanks are given to Dr. Michael Etter, Dr. Feidhlim Woods and G.M. Irene Feng for their robust support, precious opinions and efforts to encourage and organize the proceeding of this publication. This study was supported by NephroCare Asia Pacific, Taiwan Division (Grand No. 102030).

Author information

Authors and Affiliations

  1. An Hsin QingShui Clinic, Taichung, Taiwan

    Chen Huan-Sheng

  2. Sheng An Clinic, Yunlin, Taiwan

    Chang Yeong-Chang & Lee Chia-Chen

  3. Dialysis Center, Fu Ping Hospital, Taichung, Taiwan

    Hsieh Ming-Hsing & Tseng Fan-Lieh

  4. Dialysis Center, Yuan Lin Ho’s Hospital, Changhua, Taiwan

    Lin Chu-Cheng

  5. Department of Nephrology, Tungs’ Taichung MetroHarbor Hospital, No. 699, Sec.1, Chungchi Rd., Wuchi Dist., Taichung City, 43503, Taiwan

    Wu Tsai-Kun, Chen Hung-Ping & Lim Paik-Seong

  6. Dialysis Center, Tseng Han Chi Hospital, Nantou, Taiwan

    Hung Sze-Hung

  7. An Hsin Chushan Clinic, Nantou, Taiwan

    Chiu Hsien-Chang

  8. Department of Nephrology, Min-Sheng General Hospital, Taoyuan, Taiwan

    Hou Chun-Cheng

  9. Department of Nephrology, Saint Paul’s Hospital, Taoyuan, Taiwan

    Cheng Chun-Ting

  10. Dialysis Center, Hsin-Jen Hospital, Taipei, Taiwan

    Liou Hung-Hsiang

  11. School of Medicine, China Medical University, Taichung, Taiwan

    Lin Chun-Ju

Authors
  1. Chen Huan-Sheng
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  2. Chang Yeong-Chang
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  3. Hsieh Ming-Hsing
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  4. Tseng Fan-Lieh
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  7. Chen Hung-Ping
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  8. Hung Sze-Hung
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  9. Chiu Hsien-Chang
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  10. Lee Chia-Chen
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  11. Hou Chun-Cheng
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  12. Cheng Chun-Ting
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  13. Liou Hung-Hsiang
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  14. Lin Chun-Ju
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  15. Lim Paik-Seong
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Corresponding author

Correspondence to Lim Paik-Seong.

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Conflict of interest

Neither Fresenius Medical Care (which markets the Body Composition Monitor) nor the sponsor had a role in study design and conduct; data management, collection, and analysis; or preparation and submission of the manuscript. All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Huan-Sheng, C., Yeong-Chang, C., Ming-Hsing, H. et al. Application of bioimpedance spectroscopy in Asian dialysis patients (ABISAD-III): a randomized controlled trial for clinical outcomes. Int Urol Nephrol 48, 1897–1909 (2016). https://doi.org/10.1007/s11255-016-1415-8

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  • DOI: https://doi.org/10.1007/s11255-016-1415-8

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