Overestimation leads to hypertension, edema and pulmonary congestion, cardiac hypertrophy and failure. This method is inaccurate, and many patients suffer from the consequences of over- or under-estimation of their dry weight. Today, clinical estimation of dry weight is based on physical examination. Dry weight is defined as the post-dialysis weight under which a patient suffers (more often than not) from symptoms of hypotension. Fluid removal is dependent upon estimation of dry weight. Introduction Patients with end-stage renal disease (ESRD) cannot regulate their fluid balance, and are dependent on dialysis for fluid removal. Hemodialysis Complication End Stage Renal Diseaseĭiagnostic Test: sonographic measurement of inferior vena cava diameter A crossover design is intended to examine the effect of IVCD measurement on quality of life and rate of hemodynamic adversities as compared with traditional estimation of dry weight. In this study, we aim to assess the applicability and clinical utility of this method in our dialysis units. In a single-center, blinded and controlled trial it has been shown to improve clinical outcomes in patients receiving hemodialysis. It is available, inexpensive and efficient, yet operator-dependent. Sonographic measurement of the inferior vena cava diameter (IVCD) is a method under investigation for assessing hydration status. Several techniques have been proposed to asses hydration status in dialysis patient, among them measurement of bioimpedance and biochemical markers. Current methods are imprecise, and thus many patients are hype- or hypovolemic, and suffer respective consequences such as hypertension, pulmonary congestion, cardiac hypertrophy, chronic dehydration, hypotension and shock. Why Should I Register and Submit Results?ĭetermination of dry weight in patients with end-stage renal disease treated with hemodialysis is an unmet challenge in clinical nephrology.Bioimpedance spectroscopy (BIS) is a useful and sensitive tool for the assessment of fluid status in clinically euvolumic nondialytic CKD patients. Conclusions: Volume overload and malnutrition were common across the spectrum of South African CKD cohorts volume overload was associated with malnutrition, inflammation, and atherosclerosis. Lean tissue index, inflammation, and atherosclerosis were associated with volume overload. Using physical examination findings as the reference measurements for volume overload, the area under the concentration curves for BCM and IVCD measurements were 0.866 (sensitivity 82%, specificity 74%, p < 0.001) and 0.727 (sensitivity 57%, specificity 70%, p < 0.001), respectively. Results: Fluid overload and malnutrition were present in 68% and 63% of studied patients, respectively. Serum interleukin-6 (IL-6) and C-reactive protein (CRP) levels were measured as markers of inflammation. Cardiac dimension measurements, and inferior vena cava diameter (IVCD) and carotid intima media thickness were assessed by echocardiography and ultrasonography, respectively. A BCM was used to assess fluid and nutritional status. Methods: 160 participants comprising hemodialysis, peritoneal dialysis, stage 3 CKD patients, and healthy controls (40 in each group) were studied. We also evaluated the usefulness of BCM measurement in assessing volume overload. This study aimed to assess volume and nutritional status among South African CKD participants and determine the relationship between malnutrition, inflammation, atherosclerosis, and volume overload using a body composition monitor (BCM). Abstract Background: Fluid retention occurs early in chronic kidney disease (CKD) resulting in increased cardiovascular morbidity and mortality.
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