title: Methods and reproducibility of measurement of resistivity in the calf using regional bioimpedance analysis.
abstract: The usefulness of regional bioimpedance analysis (RBIA) in determining the dry weight in dialysis patients is currently being investigated. The aim of this study was to evaluate the reproducibility of measurement of resistivity in the calf.
  
  
  METHODS
  Twenty-five normal subjects and 10 patients undergoing regular hemodialysis were studied. Four electrodes inserted into a blood pressure cuff were placed on the calf. Bioimpedance was continuously measured over 3- to 5-min periods (Xitron Hydra). After a resting period of 1 min, cuff pressure was increased to above the systolic blood pressure (SBP) for a few seconds to expel excess ECF fluid and then deflated. The effect on recordings of moving the electrodes 2 cm higher and then 2 cm lower than the normal position was studied in 8 normal subjects. In a second study of reproducibility, post-dialysis measurements were made twice in 10 patients who maintained the same post-dialysis target weight throughout the study period.
  
  
  RESULTS
  The mean resting resistivity rho(0) in normal subjects was 532.6 +/- 95 omega.cm rising to 583.9 +/- 99.7 omega.cm when cuff pressure was applied rho(p). The average values of rho(0) and rho(p) in patients post-dialysis were 489 +/- 74 and 537 +/- 77 respectively showing that there were no significant differences in rho(0) and rho(p) between normal subjects and patients post-dialysis. The mean values of change in resistivity when the electrodes were shifted between the lowest and highest positions on the calf were -3.66 +/- 4.45 and -1.44 +/- 3.82%, respectively. Repeat measurement of resistivity in patients post-dialysis varied by 2.04 +/- 2.29% while post-dialysis body weight varied by 0.17 +/- 0.47%.
  
  
  CONCLUSIONS
  In this study, resistivity measurement by RBIA at the calf showed similar levels of fluid loading in patients post-dialysis as in normal subjects. This study also showed that change in electrode position resulted in a mean change in resistivity of <5% and repeated measurements showed a change in resistivity <3% while body weight changes were <0.2%. This technique appears to have an acceptable level of reproducibility for its application to the assessment of patient hydration.
authors.affiliation: Renal Research Institute and Division of Nephrology and Hypertension, Beth Israel Medical Center, New York, NY, USA. fzhu@rriny.com
authors.forename: Fansan
authors.initials: F
authors.lastname: Zhu
authors.forename: Shubho
authors.initials: S
authors.lastname: Sarkar
authors.forename: Charoen
authors.initials: C
authors.lastname: Kaitwatcharachai
authors.forename: Roger
authors.initials: R
authors.lastname: Greenwood
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco
authors.forename: Nathan W
authors.initials: NW
authors.lastname: Levin
mesh_terms: D000328:Adult; D000368:Aged; D001823:Body Composition; D016022:Case-Control Studies; D003681:Dehydration / Q000517:prevention & control; D017097:Electric Impedance; D004566:Electrodes; D006801:Humans; D007022:Hypotension / Q000517:prevention & control; D007866:Leg / Q000502:physiology*; D008722:Methods; D008875:Middle Aged; D006435:Renal Dialysis; D015203:Reproducibility of Results; D014882:Water-Electrolyte Balance