Changes in bioimpedance analysis components before and after hemodialysis
김현숙, 최광호, 심광언, 이정훈, 허남주, 주권욱, 윤정우, 오윤규,
소속 상세정보
김현숙 ( Kim Hyun-Suk )
Hallym University College of Medicine Hallym University Chuncheon Sacred Heart Hospital Department of Internal Medicine
최광호 ( Choi Gwang-Ho )
Hallym University College of Medicine Hallym University Chuncheon Sacred Heart Hospital Department of Internal Medicine
심광언 ( Shim Kwang-Eon )
Hallym University College of Medicine Hallym University Chuncheon Sacred Heart Hospital Department of Internal Medicine
이정훈 ( Lee Jung-Hoon )
Hallym University College of Medicine Hallym University Chuncheon Sacred Heart Hospital Department of Internal Medicine
허남주 ( Heo Nam-Ju )
Seoul National University Hospital Healthcare System Gangnam Center Department of Internal Medicine
주권욱 ( Joo Kwon-Wook )
Seoul National University Hospital Department of Internal Medicine
윤정우 ( Yoon Jong-Woo )
Hallym University College of Medicine Hallym University Chuncheon Sacred Heart Hospital Department of Internal Medicine
오윤규 ( Oh Yun-Kyu )
Seoul National University Boramae Medical Center Department of Internal Medicine
Abstract
Background: This study compared nutritional parameters in hemodialysis (HD) subjects and controls using bioimpedance analysis (BIA) and investigated how BIA components changed before and after HD.
Methods: This cross-sectional study included 147 subjects on maintenance HD from two hospitals and 298 propensity score-matched controls from one healthcare center. BIA was performed pre- and post-HD at mid-week dialysis sessions.
Results: Extracellular water/total body water (ECW/TBW) and waist-hip ratio were higher in the HD patients; the other variables were higher in the control group. The cardiothoracic ratio correlated best with overhydration (r = 0.425, P < 0.01) in HD subjects. Blood pressure, hemoglobin, creatinine, and uric acid positively correlated with the lean tissue index in controls; however, most of these nutritional markers did not show significant correlations in HD subjects. Normal hydrated weight was predicted to be higher in the pre-HD than post-HD measurements. Predicted ultrafiltration (UF) volume difference based on pre- and post-HD ECW/TBW and measured UF volume difference showed a close correlation (r2 = 0.924, P < 0.01). Remarkably, the leg phase angle increased in the post-HD period.
Conclusion: The estimated normal hydrated weight using ECW/TBW can be a good marker for determining dry weight. HD subjects had higher ECW/TBW but most nutritional indices were inferior to those of controls. It was possible to predict UF volume differences using BIA, but the post-HD increase in leg phase angle, a nutritional marker, must be interpreted with caution.
키워드
Bioimpedance; Hemodialysis; Lean tissue index; Nutritional status; Overhydration
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