Effect of Fluid Management Guided by Bioimpedance Spectroscopy on Cardiovascular Parameters in Hemodialysis Patients: A Randomized Controlled Trial

Basit Öğe Kaydı
dc.contributor.authorHur, Ender
dc.contributor.authorUsta, Mehmet
dc.contributor.authorToz, Huseyin
dc.contributor.authorAsci, Gulay
dc.contributor.authorWabel, Peter
dc.contributor.authorKahvecioglu, Serdar
dc.contributor.authorKayikcioglu, Meral
dc.contributor.authorDemirci, Meltem Sezis
dc.contributor.authorOzkahya, Mehmet
dc.contributor.authorDuman, Soner
dc.contributor.authorOk, Ercan
dc.date.accessioned2019-10-27T21:52:08Z
dc.date.available2019-10-27T21:52:08Z
dc.date.issued2013
dc.departmentEge Üniversitesien_US
dc.description.abstractBackground: Fluid overload is the main determinant of hypertension and left ventricular hypertrophy in hemodialysis patients. However, assessment of fluid overload can be difficult in clinical practice. We investigated whether objective measurement of fluid overload with bioimpedance spectroscopy is helpful in optimizing fluid status. Study Design: Prospective, randomized, and controlled study. Setting & Participants: 156 hemodialysis patients from 2 centers were randomly assigned to 2 groups. Intervention: Dry weight was assessed by routine clinical practice and fluid overload was assessed by bioimpedance spectroscopy in both groups. In the intervention group (n = 78), fluid overload information was provided to treating physicians and used to adjust fluid removal during dialysis. In the control group (n = 78), fluid overload information was not provided to treating physicians and fluid removal during dialysis was adjusted according to usual clinical practice. Outcomes: The primary outcome was regression of left ventricular mass index during a 1-year follow-up. Improvement in blood pressure and left atrial volume were the main secondary outcomes. Changes in arterial stiffness parameters were additional outcomes. Measurements: Fluid overload was assessed twice monthly in the intervention group and every 3 months in the control group before the mid-or end-week hemodialysis session. Echocardiography, 48-hour ambulatory blood pressure measurement, and pulse wave analysis were performed at baseline and 12 months. Results: Baseline fluid overload parameters in the intervention and control groups were 1.45 +/- 1.11 (SD) and 1.44 +/- 1.12 L, respectively (P = 0.7). Time-averaged fluid overload values significantly decreased in the intervention group (mean difference, -0.5 +/- 0.8 L), but not in the control group (mean difference, 0.1 +/- 1.2 L), and the mean difference between groups was -0.5 L (95% CI, -0.8 to -0.2; P = 0.001). Left ventricular mass index regressed from 131 +/- 36 to 116 +/- 29 g/m(2) (P < 0.001) in the intervention group, but not in the control group (121 +/- 35 to 120 +/- 30 g/m(2); P = 0.9); mean difference between groups was -10.2 g/m(2) (95% CI, -19.2 to -1.17 g/m(2); P = 0.04). In addition, values for left atrial volume index, blood pressure, and arterial stiffness parameters decreased in the intervention group, but not in the control group. Limitations: Ambulatory blood pressure data were not available for all patients. Conclusions: Assessment of fluid overload with bioimpedance spectroscopy provides better management of fluid status, leading to regression of left ventricular mass index, decrease in blood pressure, and improvement in arterial stiffness. (c) 2013 by the National Kidney Foundation, Inc.en_US
dc.description.sponsorshipEuropean Nephrology and Dialysis Instituteen_US
dc.description.sponsorshipThe study was supported by the European Nephrology and Dialysis Institute with an unrestricted grant. The study was performed in Fresenius Medical Care HD clinics in Turkey. Aside from the involvement of a Fresenius Medical Care employee (Dr Wabel), neither Fresenius Medical Care (which markets the Body Composition Monitor) nor the sponsor had a role in study design and conduct; data management, collection, and analysis; or preparation and submission of the manuscript.en_US
dc.identifier.doi10.1053/j.ajkd.2012.12.017en_US
dc.identifier.endpage965en_US
dc.identifier.issn0272-6386
dc.identifier.issue6en_US
dc.identifier.pmid23415416en_US
dc.identifier.scopusqualityN/Aen_US
dc.identifier.startpage957en_US
dc.identifier.urihttps://doi.org/10.1053/j.ajkd.2012.12.017
dc.identifier.urihttps://hdl.handle.net/11454/47509
dc.identifier.volume61en_US
dc.identifier.wosWOS:000318999200017en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherW B Saunders Co-Elsevier Incen_US
dc.relation.ispartofAmerican Journal of Kidney Diseasesen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectBioimpedance spectroscopyen_US
dc.subjecthemodialysisen_US
dc.subjecthypervolemiaen_US
dc.subjectfluid overloaden_US
dc.subjectleft ventricular hypertrophyen_US
dc.titleEffect of Fluid Management Guided by Bioimpedance Spectroscopy on Cardiovascular Parameters in Hemodialysis Patients: A Randomized Controlled Trialen_US
dc.typeArticleen_US

Dosyalar

Koleksiyon

WoS İndeksli Yayınlar Koleksiyonu
PubMed İndeksli Yayın Koleksiyonu
Scopus İndeksli Yayınlar Koleksiyonu