Document Detail


Bioelectric impedance predicts total body water, blood pressure, and heart rate during hemodialysis in children and adolescents.
MedLine Citation:
PMID:  18410888     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purposes of our study were to: (1) assess if changes in the volemic status of children and adolescents over the course of standard dialysis could be observed using bioelectric impedance (BIA); and (2) evaluate whether the variability of blood pressure (systolic blood pressure, SBP; diastolic blood pressure, DBP) and heart rate (HR) could be explained by independent variables from BIA data. DESIGN: We used a randomized, single-blinded treatment and repeated-measures design. SETTING: This study took place at the DaVita Children's Dialysis Center (Chicago, IL). PATIENTS: There were 7 subjects, aged 10 to 16 years. INTERVENTION: Two identical standard hemodialysis (HD) sessions were completed, with data collected five times during each HD session: pre-HD, intra-HD (hours 1, 2, and 3), and post-HD. Endpoints included total body water (TBW), resistance (R), reactance (Xc), bioimpedance vector |Z|, supine and sitting SBP, DBP, and HR. Standing SBP, DBP, and HR were collected pre-HD and post-HD. RESULTS: No differences were observed in TBW between HD sessions for all subjects. However, TBW decreased throughout the HD sessions for all subjects (although no significant differences were seen between hour 3 and post-HD). Reactance (representative of extracellular water) correlated with supine, sitting, and standing SBP (r = 0.55, 0.59, and 0.51, respectively; P < or = .008). The bioimpedance vector increased beginning at hour 1 (P < .001), reflective of a decline in tissue hydration over the course of HD. CONCLUSIONS: Weight gain in end-stage kidney disease patients is largely fluid. Thus, the use of BIA during HD may aid in the prediction of cardiovascular instability before the development of symptoms, because intravascular hypovolemia and hypotension can result from excessive ultrafiltration below the critical dry weight. In addition, BIA explains, in part, the variability of SBP, DBP, and HR during HD. We suggest that our data also demonstrates the delay in mobilization of fluid from the interstitial space for plasma refill, as evidenced by the delayed change in |Z| over HD. Bioelectric impedance is useful for explaining changes in volemic status and, in part, the variability of SBP, DBP, and HR during HD.
Authors:
Ellen R Brooks; Sahar A Fatallah-Shaykh; Craig B Langman; Kristina M Wolf; Heather E Price
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation     Volume:  18     ISSN:  1532-8503     ISO Abbreviation:  J Ren Nutr     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-04-15     Completed Date:  2008-06-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9112938     Medline TA:  J Ren Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  304-11     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Division of Kidney Diseases, Northwestern University Feinberg Medical School, Children's Memorial Hospital, Chicago, Illinois 60614, USA. e-brooks3@northwestern.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Blood Pressure*
Body Composition
Body Water*
Child
Electric Impedance / diagnostic use
Female
Heart Rate*
Humans
Kidney Failure, Chronic / diagnosis,  physiopathology*,  therapy*
Male
Predictive Value of Tests
Renal Dialysis*
Single-Blind Method

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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