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Pediatric Nephrology

, Volume 29, Issue 8, pp 1417–1423 | Cite as

Whole-body single-frequency bioimpedance analysis in pediatric hemodialysis patients

  • Gia Oh
  • Cynthia Wong
  • Brandy Begin
  • Kari Salsbery
  • Scott Sutherland
  • Abanti Chaudhuri
Original Article

Abstract

Background

We hypothesized that the percent change in resistance (%RΔ) from bioimpedance analysis (BIA) measurements during hemodialysis (HD) can provide information on pediatric HD patients’ hydration status.

Methods

Whole-body single-frequency BIA measurements were obtained before HD, each hour on HD, and after HD during two HD sessions. Pre-and post-HD weights, blood pressures, Crit-Line® measurements, and intradialytic symptoms were collected on the day of the BIA measurements.

Results

One hundred and thirty BIA measurements were obtained from 14 HD patients. The group was 43 % girls, and the mean age was 13.2 ± 4.4 years. Percent change in resistance was 13.5 ± 10.8 % at the end of HD; %RΔ correlated with percent body weight change (%BWΔ) following HD (r = −0.83, P < 0.01), as well as with percent blood volume change (%BVΔ) (r = −0.79, P < 0.01). The %RΔ was similar between patients with and without hypertension immediately before HD and was greater in those with intradialytic symptoms (19.1 ± 7.7 %) than in those without (9.9 ± 11.2 %) (P = 0.02). Patients with left ventricular hypertrophy (LVH) had lower %RΔ (7.2 ± 9.7 %) than those without (19.5 ± 7.7 %) (P = 0.03). Left ventricular mass index (LVMI) also correlated strongly with %RΔ (r = −0.79, P = 0.004) and %BWΔ (r = 0.82, P = 0.002).

Conclusions

Our study showed that %RΔ strongly correlates with %BWΔ and %BVΔ and that %RΔ also correlated with intradialytic symptoms and LVMI.

Keywords

Bioimpedance Resistance Hemodialysis Fluid Hydration Dry weight Pediatric 

References

  1. 1.
    Mitsnefes MM (2012) Cardiovascular disease in children with chronic kidney disease. J Am Soc Nephrol 23:578–585PubMedCentralPubMedCrossRefGoogle Scholar
  2. 2.
    Holtta T, Happonen JM, Ronnholm K, Fyhrquist F, Holmberg C (2001) Hypertension, cardiac state, and the role of volume overload during peritoneal dialysis. Pediatr Nephrol 16:324–331PubMedCrossRefGoogle Scholar
  3. 3.
    Agarwal R (2010) Hypervolemia is associated with increased mortality among hemodialysis patients. Hypertension 56:512–517PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Piccoli A, Rossi B, Pillon L, Bucciante G (1994) A new method for monitoring body fluid variation by bioimpedance analysis: the RXc graph. Kidney Int 46:534–539PubMedCrossRefGoogle Scholar
  5. 5.
    Kuhlmann MK, Zhu F, Seibert E, Levin NW (2005) Bioimpedance, dry weight and blood pressure control: new methods and consequences. Curr Opin Nephrol Hypertens 14:543–549PubMedCrossRefGoogle Scholar
  6. 6.
    Tattersall J (2009) Bioimpedance analysis in dialysis: state of the art and what we can expect. Blood Purif 27:70–74PubMedCrossRefGoogle Scholar
  7. 7.
    Piccoli A (1998) Identification of operational clues to dry weight prescription in hemodialysis using bioimpedance vector analysis. The Italian Hemodialysis-Bioelectrical Impedance Analysis (HD-BIA) Study Group. Kidney Int 53:1036–1043PubMedCrossRefGoogle Scholar
  8. 8.
    Paglialonga F, Ardissino G, Galli MA, Scarfia RV, Testa S, Edefonti A (2012) Bioimpedance analysis and cardiovascular status in pediatric patients on chronic hemodialysis. Hemodial Int Suppl 1:S20–S25CrossRefGoogle Scholar
  9. 9.
    Brooks ER, Fatallah-Shaykh SA, Langman CB, Wolf KM, Price HE (2008) Bioelectric impedance predicts total body water, blood pressure, and heart rate during hemodialysis in children and adolescents. J Ren Nutr 18:304–311PubMedCrossRefGoogle Scholar
  10. 10.
    Di Iorio BR, Scalfi L, Terracciano V, Bellizzi V (2004) A systematic evaluation of bioelectrical impedance measurement after hemodialysis session. Kidney Int 65:2435–2440PubMedCrossRefGoogle Scholar
  11. 11.
    (2004) The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 114:555-576Google Scholar
  12. 12.
    Khoury PR, Mitsnefes M, Daniels SR, Kimball TR (2009) Age-specific reference intervals for indexed left ventricular mass in children. J Am Soc Echocardiogr 22:709–714PubMedCrossRefGoogle Scholar
  13. 13.
    Sutherland SM, Zappitelli M, Alexander SR, Chua AN, Brophy PD, Bunchman TE, Hackbarth R, Somers MJ, Baum M, Symons JM, Flores FX, Benfield M, Askenazi D, Chand D, Fortenberry JD, Mahan JD, McBryde K, Blowey D, Goldstein SL (2010) Fluid overload and mortality in children receiving continuous renal replacement therapy: the prospective pediatric continuous renal replacement therapy registry. Am J Kidney Dis 55:316–325PubMedCrossRefGoogle Scholar
  14. 14.
    Martin LC, Franco RJ, Gavras I, Matsubara BB, Garcia S, Caramori JT, Barretti BB, Balbi AL, Barsanti R, Padovani C, Gavras H (2004) Association between hypervolemia and ventricular hypertrophy in hemodialysis patients. Am J Hypertens 17:1163–1169PubMedCrossRefGoogle Scholar
  15. 15.
    Wizemann V, Wabel P, Chamney P, Zaluska W, Moissl U, Rode C, Malecka-Masalska T, Marcelli D (2009) The mortality risk of overhydration in haemodialysis patients. Nephrol Dial Transplant 24:1574–1579PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    Odudu A, McIntyre C (2012) Volume is not the only key to hypertension control in dialysis patients. Nephron Clin Pract 120:c173–c177PubMedCrossRefGoogle Scholar
  17. 17.
    Basile C, Vernaglione L, Di Iorio B, Bellizzi V, Chimienti D, Lomonte C, Rubino A, D’Ambrosio N (2007) Development and validation of bioimpedance analysis prediction equations for dry weight in hemodialysis patients. Clin J Am Soc Nephrol 2:675–680PubMedCrossRefGoogle Scholar
  18. 18.
    Zaloszyc A, Schaefer B, Schaefer F, Krid S, Salomon R, Niaudet P, Schmitt CP, Fischbach M (2013) Hydration measurement by bioimpedance spectroscopy and blood pressure management in children on hemodialysis. Pediatr Nephrol 28:2169–2177PubMedCrossRefGoogle Scholar
  19. 19.
    Matthie J, Zarowitz B, De Lorenzo A, Andreoli A, Katzarski K, Pan G, Withers P (1998) Analytic assessment of the various bioimpedance methods used to estimate body water. J Appl Physiol 84:1801–1816PubMedGoogle Scholar
  20. 20.
    Matthie JR, Withers PO (1998) Bioimpedance: 50 kHz parallel reactance and the prediction of body cell mass. Am J Clin Nutr 68:403–404PubMedGoogle Scholar
  21. 21.
    Reddan DN, Szczech LA, Hasselblad V, Lowrie EG, Lindsay RM, Himmelfarb J, Toto RD, Stivelman J, Winchester JF, Zillman LA, Califf RM, Owen WF Jr (2005) Intradialytic blood volume monitoring in ambulatory hemodialysis patients: a randomized trial. J Am Soc Nephrol 16:2162–2169PubMedCrossRefGoogle Scholar

Copyright information

© IPNA 2014

Authors and Affiliations

  • Gia Oh
    • 1
  • Cynthia Wong
    • 1
  • Brandy Begin
    • 2
  • Kari Salsbery
    • 3
  • Scott Sutherland
    • 1
  • Abanti Chaudhuri
    • 1
  1. 1.Department of Pediatrics, Division of NephrologyStanford UniversityStanfordUSA
  2. 2.Lucile Packard Children’s HospitalPalo AltoUSA
  3. 3.Pediatric Endocrine SpecialistsDuluthUSA

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