medigraphic.com

2003, Number 3

<< Back Next >>

Rev Med Inst Mex Seguro Soc 2003; 41 (3)

Total Corporal Water in Patients in Hemodialysis: Different Methods of Measurement

Vázquez R, Pérez GH, Ventura MJ, Paniagua R

Language: Spanish
References: 22
Page: 229-233
PDF size: 65.66 Kb.


ABSTRACT

Introduction: Measurements of total body water (TBW) are useful to evaluate dialysis prescription and volume expansion in uremic patients, but some methods are complex or imprecise. Objective: Our objective was to assess usefulness of different methods for measuring TBW, edema effect, and precision for detecting ultrafiltration-induced variations. Material and Methods: We conducted a cross-sectional study of patients on chronic hemodialysis without acute complications. Prior to and after hemodialysis session, TBW was measured by body weight percentage, body weight percentage by gender, body surface area, Watson method, and bioelectric impedance (IBE). These were analyzed stratifying for edema and by capacity for detecting ultrafiltration-induced TBW variations. Results: Thirty one patients were studied. Highest values of TBW corresponded to assessment by fixed weight percentage (30.1 ± 6.7 %) and lowest to assessment by body surface area (27.1 ± 5.9 %). Correlations were significant among all tested methods (r = 0.80 to 0.98), but edema increased resulting dispersion, particularly when TBW was calculated as fixed body weight percentage. Ultrafiltration volume of 2.5± 1.5 L was induced. IBE was the method that detected more precisely induced variation; correlation coefficient between ultrafiltration volume and measured volume was r = 0.70. Conclusions: IBE was the method least affected by edema. It also had best correlation with TBW changes induced by ultrafiltration. Therefore, IBE is the most reliable method to measure TBW.


REFERENCES

  1. 1. Roubenhoff R, Kehayias JJ. The meaning and measurement of lean body mass. Nutr Rev 1991;49: 163-175.

  2. 2. Gotch FA, Yarian S, Keen M. A kinetic survey of US hemodialysis prescriptions. Am J Kidney Dis 1990;15:511-515.

  3. 3. Nakai S, Shinzato T, Fujita Y, Maeda K. Relationship of protein catabolic rate or Kt/V with morbidity. ASAIO J 1993;39:M602-M605.

  4. 4. Tzamaloukas AH. In search of ideal V. Perit Dial Int 1996;16:345-346.

  5. 5. Low CL, Bailie GR, Rasmussen R, Eisele G. Variability in creatinine clearance (CCR) and KT/V due to different methods of calculating volume and CCR. Perit Dial Int 1996;16:366-369.

  6. 6. Cooper BA, Aslani A, Ryan M, Zhu FYP, Ibels LS, Allen BJ, Pollock CA. Comparing different methods of assessing body composition in end-stage renal failure. Kidney Int 2000;58:408-416.

  7. 7. Hume R, Weyers E. Relationship between total body water and surface area in normal and obese subjects. J Clin Pathol 1971;4:234-238.

  8. 8. Watson PE, Watson ID, Batt RD. Total body water volumes for adult males and females estimated from simple anthropometric measurements. Am J Clin Nutr 1980;33:27-39.

  9. 9. Mitch WE, Wilcox CS. Disorders of body fluids, sodium and potassium in chronic renal failure. Am J Med 1982;72:536-550.

  10. Coles GA. Body composition in chronic renal failure. QJM 1972;41:25-47.

  11. Tzamaloukas AH. Effect of edema on urea kinetic studies in peritoneal dialysis. Perit Dial Int 1994;14: 398-401.

  12. Lukaski HC. Methods for the assessment of human body composition: Traditional and new. Am J Clin Nutr 1987;46:537-556.

  13. Piccoli A. Identification of operational clues to dry weight prescription in hemodialysis using bioimpedance vector analysis. Kidney Int 1988;53:1036-1043.

  14. Chertow GM, Lazarus JM, Lew NL, Ma L, Lowrie EG. Bioimpedance norms for the hemodialysis population. Kidney Int 1997;52:1617-1621.

  15. Sternby J. Significance of distribution volume in dialysis quantification. Semin Dial 2001;14:278-283.

  16. Leypoldt JK, Cheung AK, Delmez JA, Gassman JJ, Levin NW, Lewis JAB, et al. The HEMO Study Group: Relationship between volume status and blood pressure during chronic hemodialysis. Kid-ney Int 2002;61:266-275.

  17. Kooman JP, Leunissen KML. Cardiovascular aspects in renal disease. Curr Opin Nephrol Hypertens 1993; 2:791-797.

  18. Kloppenburg WD, Stegeman CA, De-Jong PE, Huisman RM. Anthropometry-based equations overestimate the urea distribution volume in hemo-dialysis patients. Kidney Int 2001;59:1165-1174.

  19. Chumlea WC, Guo SS, Zeller CM, Reo NV, Baum-gartner RN, Garry PJ, et al. Total body water refe-rence values and prediction equations for adults. Kidney Int 2001;59:2250-2258.

  20. Himmelfarb J, Evanson J, Hakim RM, Freedman S, Shyr Y, Ikizler TA. Urea volume of distribution exceeds total body water in patients with acute renal failure. Kidney Int 2002;61:317-323.

  21. Thomassett A. Bioelectrical properties of tissue. Lyon Med 1963;22:1325-1352.

  22. Jaeger JQ, Mehta RL. Assessment of dry weight in hemodialysis. An overview. J An Soc Nephrol 1999; 10:392-403.




2020     |     www.medigraphic.com