EVOLUTION OF BLOOD PRESSURE IN HEMODIALYSIS PATIENTS WITH CHRONIC KIDNEY DISEASE WITH DRY WEIGHT ASSESSMENT USING CLINICAL EVALUATION WITH AND WITHOUT BIOIMPEDANCE SPECTROSCOPY AT A MEXICAN TERTIARY C

E-Poster

https://storage.unitedwebnetwork.com/files/1099/cda8c6b76e632720162d694b39b84dea.pdf

Abstract Title

First Name *

Diana Laura

Last Name *

Muñoz Montes de Oca

Co-author 1

María del Refugio Santisbais Beas santisbaism@gmail.com Department of Nephrology and Organ Transplant Unit, Specialties Hospital, National Western Medical Centre, Mexican Institute of Social Security Servicio de Nefrología y Trasplante Guadalajara

Co-author 2

Miguel Angel Tijerina Gelacio miguel_atg@outlook.com Department of Nephrology and Organ Transplant Unit, Specialties Hospital, National Western Medical Centre, Mexican Institute of Social Security Servicio de Nefrología y Trasplante Guadalajara

Co-author 3

Moisés Cruz Landino moiseslandino@gmail.com Department of Nephrology and Organ Transplant Unit, Specialties Hospital, National Western Medical Centre, Mexican Institute of Social Security Servicio de Nefrología y Trasplante Guadalajara

Co-author 4

Mariana Castellanos Rojas mariana_castellanos_r@hotmail.com Department of Nephrology and Organ Transplant Unit, Specialties Hospital, National Western Medical Centre, Mexican Institute of Social Security Servicio de Nefrología y Trasplante Guadalajara

Co-author 5

Salvador Mendoza Cabrera salvador_mendozamx@yahoo.com.mx Department of Nephrology and Organ Transplant Unit, Specialties Hospital, National Western Medical Centre, Mexican Institute of Social Security Servicio de Nefrología y Trasplante Guadalajara

Co-author 6

Adriana Banda López adribalo89@gmail.com Department of Nephrology and Organ Transplant Unit, Specialties Hospital, National Western Medical Centre, Mexican Institute of Social Security Servicio de Nefrología y Trasplante Guadalajara

Co-author 7

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

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Co-author 15

Introduction

Optimizing ultrafiltration in hemodialysis (HD) patients helps decrease symptoms related to fluid overload and hypotension. A non-invasive, precise, and dynamic approach to the fluid status in HD patients is a state of art in the nephrologist setting. Bioimpedance Spectroscopy (BIS) allows examination of dry-weight status and a proper adjustment of HD prescription, affecting blood pressure (BP) directly. The aim of this study was to compare BIS and clinical assessment and clinical assessment only of dry weight and their impact on BP.

Methods

A randomized, crossover clinical trial in chronic HD patients in “Centro Medico Nacional de Occidente”. Inclusion criteria: ≥18 years, HD ≥6 months, ≥2 sessions per week. Exclusion criteria: pregnancy, heart failure NYHA III-IV, <1 month since prior cardiac or pulmonary evidence of fluid overload, <3 months since prior vascular infectious event. Dry-weight target was set by two methods: BIS, Fresenius Medical Care, performed after the long interdialytic period 30 minutes prior HD session. Clinical assessment consisted of body weight measurement before the HD session, and indicators such as BP, peripheral edema, crackles, and dyspnea. Quantitative parametric variables were analyzed by performing Student's t-test.

Figure 1 resumes study methods.

Results

A total of 36 participants were enrolled and randomized into two groups: 52.7% women, with a mean age of 36.5 (IQR 30.7-39.5), and a mean time in HD 25.44 months. In the first phase of the study, the mean dry weight for group A was 64.1 + 13.2, and in the second phase of the study, it was 65.2 + 12.8. Table 1 resumes the study findings. Group B was 62.5 + 21.2 and 63.4 + 21.7, respectively. BIS showed an average weight loss of -0.85 kg (DE + 5.025), with a reduction in systolic BP of 10.8 mmHg, diastolic BP of 4.7 mmHg, and mean BP of 6.6 mmHg. The clinical assessment only arm did not show statistical significance in change of BP values.

Conclusions

BIS offers a non-invasive, safe, accessible, and reproducible tool for the assessment of dry weight in HD patients. The evaluation of dry weight with BIS can be a good strategy to improve BP control in the HD population.

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