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Assessment of the volume status using multifrequency bioimpedance spectroscopy in comparison to clinical examination in the incident peritoneal dialysis patients (CROSBI ID 651036)

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Karmelić, Dora ; Dorčić, Gordan ; Ferenčić, Antun ; Vujičić, Božidar Assessment of the volume status using multifrequency bioimpedance spectroscopy in comparison to clinical examination in the incident peritoneal dialysis patients // Liječnički vjesnik : glasilo Hrvatskog liječničkog zbora. Suplement. 2012. str. 40-40

Podaci o odgovornosti

Karmelić, Dora ; Dorčić, Gordan ; Ferenčić, Antun ; Vujičić, Božidar

engleski

Assessment of the volume status using multifrequency bioimpedance spectroscopy in comparison to clinical examination in the incident peritoneal dialysis patients

Introduction. Overhydration is the most common cause of hypertension in peritoneal dialysis (PD) patients. It represents an independent mortality risk factor in this patient group. In purpose of achieving optimal fluid balance and regulation of blood pressure, it's important to define ˝dry weight˝ which is not quite simple job. ˝Dry weight˝ is defined as the lowest weight which the patient can handle without intradyalitic complications and/or hypertension, and without clinical signs of hypervolemia. Determining the volume status in PD patients represents a clinical challenge, because those patients still have preserved a residual renal function. The most used method for the volume status assessment is clinical examination (CE) but it's limited for subjectivity. A new method that has been recently used in clinical practice is multifrequency bioimpedance spectroscopy (MBS). It is a simple, objective and non-invasive procedure, without ionising radiation and short to perform by patient's bed. Objective. To assess volume status in PD patients by CE and MBS, and to compare overhydration results. Subjects and methods. We analysed 8 incident PD patients from January 1st, 2012 at the Department of nephrology and dialysis, Clinical hospital centre Rijeka. Measurements were performed on months 0, 1, and 3. Mont 0 was used as the first peritoneal dialysate exchange time. Exclusion criteria were pregnancy and breastfeeding, clinical and laboratory signs of systemic inflammation, malignant disease, permanent cardiac electro stimulator or defibrillator, and patients with amputated limbs. According to CE we have separated patients into five groups. Patient in group 1 and 2 were hypervolemic. The evaluation was made by the presence of pre-tibial or ankle oedema, percussion and auscultation of lungs, skin turgor test, bucal mucosa wetness, eyeballs tonus and arterial blood pressure measurement. Measurment lasts arround ten minutes. Determination of volume status by the MBS method was conducted using BCM - Body Composition Monitor (Fresenius Medical Care, Germany) after the patient has finished dialysate exchange. Patients with overhydration more than 1 litre were hypervolemic. In supine position we disinfected the patient’s hand and leg on the same side of the body, and applied two electrodes. After that we performed measurement which lasts around two minutes. Statistical analysis was made using the statistical programme package MedCalc, version 11.5 (MedCalc, Mariakerke, Belgium). We used the correlation coefficient by Spearman. P < 0, 05 was used as statistically significant. Results. Statistical analysis of the methods demonstrated their comparability. It was shown that the two methods were well correlated. MBS vs. KP (r = -0, 727 ; P < 0, 0001 ; 95% CI = -0, 867 do -0, 479). Conclusions. In comparison with CE, MBS is comparable, harmless, fast, effective and objective. Further investigations including more patients are required before confirming this method to be a standard clinical practice for volume status assessment in PD patients. Nevertheless, our results are promising.

volume status ; multifrequency bioimpedance spectroscopy ; peritoneal dialysis

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Podaci o prilogu

40-40.

2012.

nije evidentirano

objavljeno

Podaci o matičnoj publikaciji

Liječnički vjesnik : glasilo Hrvatskog liječničkog zbora. Suplement

1330-4917

Podaci o skupu

12th ZIMS - Zagreb International Medical Summit

poster

14.11.2012-17.11.2012

Zagreb, Hrvatska

Povezanost rada

Kliničke medicinske znanosti