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Evaluation of factors affecting time to achieve dry weight among hemodialysis patients using bioimpedance spectroscopy

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Abstract

Background

Achieving and maintaining dry weight appears to be an effective strategy for controlling and maintaining normotension among hypertensive patients on hemodialysis (HD).

Objective

The present study aimed to determine the time at which the majority of patients achieve postdialysis dry weight using bioimpedance spectroscopy (BIS).

Methods

A total of 220 HD patients were prospectively assessed for fluid overload using the Fresenius body composition monitor (BCM). BCM readings were taken at 30 and 45 min postdialysis.

Results

Among the 220 patients included in this study, 120 (54.5%) achieved a euvolemic state at 30 min, and 25 (11.4%) achieved it at 45 min according to the BCM. In the multivariate analysis, vascular access other than arteriovenous fistula (AVF) (OR = 0.286, p value = 0.049) and cardiovascular disease (OR = 0.384, p value = 0.026) had a statistically significant negative association and receiving HD at Hospital Universiti Sains Malaysia (HUSM) (OR = 2.705, p value = 0.008) had a statistically significant positive association with achieving a euvolemic state at 30 min.

Conclusion

This suggests that assessing the hydration status at 45 min postdialysis in all patients or in those with identified risk factors for not achieving a euvolemic state at 30 min will provide a relatively accurate assessment for most patients.

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Acknowledgments

We are thankful to the Institute of Postgraduate Studies (IPS) of Universiti Sains Malaysia (USM) for the fellowship support (ref. no. P-FD0011/15(R)).

Funding

Authors have no support or funding for current manuscript.

Author information

Authors and Affiliations

  1. Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Penang, Malaysia

    Amjad Khan, Amer Hayat Khan & Syed Azhar Syed Sulaiman

  2. Chronic Kidney Disease Resource Centre, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerain, 16150, Kelantan, Malaysia

    Amjad Khan, Amer Hayat Khan & Azreen Syazril Adnan

  3. Department of Pharmacy, Quaid-i-Azam University, Islamabad, 45320, Pakistan

    Amjad Khan

  4. Faculty of Pharmacy and Health Sciences, University of Balochistan, Quetta, 87300, Pakistan

    Nafees Ahmad

  5. Human Genome Centre, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia

    Siew Hua Gan

Authors
  1. Amjad Khan
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  2. Amer Hayat Khan
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  3. Azreen Syazril Adnan
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  4. Syed Azhar Syed Sulaiman
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  5. Nafees Ahmad
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Contributions

Conceived and designed the experiments: AK and AHK. Performed the experiments: AK, AHK, and ASA. Analyzed the data: AK and NA. Contributed reagents/materials/analysis tools: SASS, AK, and SHG. Wrote the paper: AK. Final approval of manuscript: AHK, ASA, and SASS.

Corresponding author

Correspondence to Amjad Khan.

Ethics declarations

Competing interests

The authors declare that they have no competing interests.

Ethics approval

Our study was approved by the Human Resource Ethics Committee of Hospital Universiti Sains Malaysia (USM/JEPeM/16020058). 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.

Additional information

Strengths and limitations of the study

• This study involved heterogeneous group of patients from tertiary-level teaching hospital of Malaysia.

• Use of Fresenius body composition monitor (BCM) for dry-weight analysis.

• To the best of the authors’ knowledge, the current study is strengthened by its prospective nature, and it is the first study to evaluate and suggest the optimal time for dry weight assessments in a clinical setting.

• For determining the predictors of achieving a euvolemic state at 30 min, multivariate analysis was conducted.

• Nevertheless, a multicenter study with a large sample size and longer follow-up time is needed to confirm the findings of the current study.

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Khan, A., Khan, A.H., Adnan, A.S. et al. Evaluation of factors affecting time to achieve dry weight among hemodialysis patients using bioimpedance spectroscopy. Ir J Med Sci 188, 311–319 (2019). https://doi.org/10.1007/s11845-018-1813-2

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  • DOI: https://doi.org/10.1007/s11845-018-1813-2

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