NDT Advance Access originally published online on January 8, 2008
Nephrology Dialysis Transplantation 2008 23(3):808-812; doi:10.1093/ndt/gfm889
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Current state of bioimpedance technologies in dialysis
Renal Research Institute, New York, NY, USA
Nathan W. Levin, Renal Research Institute, 207 East 94th Street, Suite 303, New York, NY 10128, USA. Tel: +1-212-360-4900; Fax: +1-212-996-5905; E-mail: nlevin@rriny.com
Keywords: bioimpedance; body composition; body hydration; dialysis; dry weight
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Introduction |
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Determination of body hydration and nutritional status are significant problems in dialysis patients. In practice, clinical evaluation is usually used to estimate the ultrafiltration target, since accurate knowledge of dry weight is lacking. Several methods have been proposed for non-clinical dry weight assessment; these include natriuretic peptides, measurement of inferior vena cava diameter and collapsibility on inspiration by ultrasound and intradialytic relative blood volume change. Unfortunately these methods suffer from several shortcomings, such as poor specificity (natriuretic peptides), operator dependence (inferior vena cava diameter measurements) and poor correlation with extracellular volume (continuous blood volume measurement) [1].
After years of bioimpedance analysis (BIA) research in dialysis patients, this technique is now increasingly used clinically. BIA as a means to determine extracellular volume (ECV) or/and intracellular volume (ICV) has been validated by applying dilution methods as the gold standard. Body composition analysis by BIA has been compared to magnetic resonance
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Principles of bioimpedance techniques |
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Clinical application in dialysis |
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Assessment of hydration status and dry weight in hemodialysis patients
Assessment of body composition and nutritional status
BIA in peritoneal dialysis (PD)
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Problems and future areas of research |
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What are the practical differences between segmental and wrist-to-ankle methods?
Which method is superior, SFBIA or MFBIS?
Is the current body composition model correct?
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Conclusion |
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