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Bioimpedance analysis and cardiovascular status in pediatric patients on chronic hemodialysis
Author(s) -
Paglialonga Fabio,
Ardissino Gianluigi,
Galli Maria A.,
Scarfia Rosalia V.,
Testa Sara,
Edefonti Alberto
Publication year - 2012
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1542-4758.2012.00743.x
Subject(s) - medicine , hemodialysis , dialysis , left ventricular hypertrophy , incidence (geometry) , cardiology , blood pressure , pediatrics , physics , optics
Bioimpedance analysis ( BIA ) is reported to be useful in assessing dry weight ( DW ) in patients on hemodialysis ( HD ), but its exact role has never been clearly defined. We reviewed our experience of using the BIA measure of reactance ( X c) in pediatric patients on chronic HD . Our approach is currently based on identifying a range of patient‐specific X c values at which a child can be considered at DW according to a multidisciplinary assessment. Values lower than the patient‐specific limit suggests the need for a reduction in DW , whereas values higher than the limit suggest that DW should be increased. The accuracy of our approach was retrospectively assessed by analyzing the left ventricular mass index ( LVMI ) and the incidence of pulmonary edema ( PE ) in two groups: The first consisted of 13 patients (median age 15.6 years) on dialysis in 2007, before the introduction of the BIA ‐based approach; the second included 18 patients (median 14.8 years) on dialysis in 2011. In 2007, three children experienced four episodes of PE , whereas no PE occurred in 2011. The median LVMI was 56.8 g/m 2.7 in 2007, and 44.5 g/m 2.7 in 2011 (P < 0.05). The percentage of patients with LV hypertrophy ( LVMI >38.5 g/m 2.7 ) was 92.3% in 2007 and 61.1% in 2011 (P < 0.05). There were no between‐group differences in terms of blood pressure, antihypertensive medications, percentage of symptomatic sessions, or biochemistry. In conclusion, a simple approach based on BIA may be useful in assessing DW in pediatric patients on HD , and thus improve their cardiovascular status.