Introduction:
Dry Weight is the lowest possible weight a person can tolerate without developing symptoms of fluid imbalance and with the use of bare minimum anti-hypertensive medication. DW is often assessed in clinics through conventional method using patient's inter-dialytic weight gain and clinical signs, although it yields positive outcomes but is tedious and operator-dependent, despite this to determine the euvolemic state of patient is difficult due to which patient experiences several adverse events during dialysis either hypervolemia (hypertension, dyspnoea) and hypovolemia (hypotension and muscle cramps). Bioimpedance spectroscopy is a tool to determine the volume status of the patient and estimate the dry weight along with conventional method. Therefore we conducted a small study to know the efficacy of bioipmedance spectroscopy in dialysis patients.
Methods:
It is a randomized controlled study including 126 patients, randomly assigned to bioimpedance(study) group and conventional(control) group having 63 patients in each group. Patients age >18 years, regular on dialysis twice or thrice a week and no metallic implant in body are included in study. Dry weight estimation is done by using bioimpedance spectroscopy in study group and by conventional method in control group before and after dialysis every 15 days for 6 months period. At the end of study following parameters are compared- mean SBP and DBP at baseline and after 6months in both groups, mean antihypertensive medication requirement in both groups at the start of study and at the end of study, incidence of adverse events during dialysis in both groups and patient outcome at the end of study.
Results:
The study included 126 patients, mean age in study group is 56.7years and control group is 59.65years, 40 male and 86 female patients. The mean SBP/DBP at baseline and after 6 months in study group is 152/91.68mmhg and 135.5/80.81mmhg and in control group is 152.2/89.14mmhg and 139.6/82.46mmhg. The mean antihypertensive medications in study group at the start of study and at the end of study is1.67 and 1.0 and in control group is 1.67 and 1.37. Adverse events like hypotension occurred in 76 patients, 34(53.1%) in study and 42(66.6%) in control group, muscle cramps occurred in 72 patients, 32(50.8%) in study and 40(63.4%) in control group, headache occurred in 67 patients, 24(37.5%) in study and 43(69.4%) in control group, chest pain occurred in 29 patients, 7(10.9%) in study and 22(34.9%) in control group, breathing difficulty occurred in 22 patients, 4(6.3%) in study and 18(28.6%) in control group, hypertension occurred in 33 patients, 10(15.6%) in study and 23(38.3%) in control group, vomiting occurred in 23 patients, 9(14.1%) in study and 14(23%) in control group. The patient outcome like death occurred in 1(0.8%) in control group, lost to follow up in 1(0.8%) in study group, patient surviving but discontinued dialysis in 1(0.8%) in study group and patient surviving and continued dialysis in 123(97.6%) patients, 61(96.8%) in study and 62(98.4%) in control group.
Conclusions:
In this study use of bioimpedance spectroscopy for dialysis patients did not affect the overall patient outcome but mean antihypertensive medication requirement is less in study group, mean SBP/DBP is less in study group at the end of study. The occurrence of adverse events during dialysis are less in study group. Thus biopimpedance spectroscopy can be a useful tool in addition to conventional method to estimate dry weight in dialysis patients.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.