Document Detail


A non-invasive, on-line deuterium dilution technique for the measurement of total body water in haemodialysis patients.
MedLine Citation:
PMID:  18326883     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Despite its importance, total body water (TBW) is usually estimated rather than measured due to the complexity of isotope dilution methods. The aim of this study was to demonstrate the applicability in haemodialysis (HD) patients of a recently developed on-line breath test, previously validated in healthy subjects, that uses the gold standard deuterium dilution method to measure TBW. In particular we wished to show that a pre-dialysis estimation was as good as a post-dialysis equilibrated measurement in order to avoid patients needing to remain behind after dialysis treatment. METHODS: The dispersal kinetics of breath HDO, measured using a flowing afterglow mass spectrometer (FA-MS) following ingestion of D(2)O immediately post-dialysis, were determined in 12 haemodialysis patients and used to calculate the absolute TBW(PostHD) after full equilibration. TBW(PreHD) was then determined from breath samples taken immediately prior to the next dialysis. This measurement was adjusted for the interdialytic weight change and urine output (TBW(PreHD-adjusted)) and compared to the TBW(PostHD). The accuracy and precision of FA-MS was also assessed using known concentrations of deuterium-enriched water samples. RESULTS: Mean TBW(PostHD) was 50.0 +/- 9.3 L and TBW(PreHD-adjusted) was 50.7 +/- 9.0 L. They were highly correlated (R = 0.99, P < 0.001) with a CV of 2.6%. The mean difference was +0.74 L (SEM 0.35, 95% CI -0.03 to 1.51 L, P = 0.059), compatible with a daily insensible loss of 0.37 L. Accuracy and precision of FA-MS were comparable to the previous validation work. CONCLUSIONS: This non-invasive adaptation of the D isotope dilution method for determining TBW can be applied to haemodialysis patients who show deuterium equilibration kinetics identical to normal subjects; a pre-dialysis estimation may be used to determine TBW, and so avoiding the necessity to remain behind after dialysis making this suitable for application in the clinical setting.
Authors:
Cian Chan; David Smith; Patrik Spanel; Christopher W McIntyre; Simon J Davies
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-03-08
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  23     ISSN:  1460-2385     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-21     Completed Date:  2008-07-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  2064-70     Citation Subset:  IM    
Affiliation:
Department of Nephrology, University Hospital of North Staffordshire, Stoke-on-Trent ST4 7LN, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Body Water / physiology*
Breath Tests
Deuterium / diagnostic use,  pharmacokinetics*
Electric Impedance
Female
Humans
Indicator Dilution Techniques*
Kidney Failure, Chronic / diagnosis,  therapy
Male
Mass Spectrometry / methods
Middle Aged
Renal Dialysis / adverse effects,  methods*
Reproducibility of Results
Sampling Studies
Sensitivity and Specificity
Water-Electrolyte Imbalance / prevention & control
Grant Support
ID/Acronym/Agency:
//Wellcome Trust
Chemical
Reg. No./Substance:
7782-39-0/Deuterium

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


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