Calf bioimpedance ratio improves dry weight assessment and blood pressure control in hemodialysis patients.
BACKGROUND
Chronic fluid overload due to overestimation of dry weight (DW) is the major factor in the development of hypertension in hemodialysis (HD) patients. The present study was undertaken to investigate whether bioimpedance ratio in the calf (Calf-BR = impedance at 200 kHz/impedance at 5 kHz) could be a useful hydration marker for estimation of DW and facilitate better control of blood pressure (BP) in HD patients.


METHODS
Target range of Calf-BR was derived from 157 healthy Chinese subjects. Post-dialysis Calf-BR was measured in 117 stable, non-edematous HD patients. Those with Calf-BR(s) above target level had their DW(s) gradually reduced under the guidance of Calf-BR.


RESULTS
The Calf-BR was normally distributed and increased with age, but was independent of BMI and gender in both healthy subjects and dialysis patients. HD patients with Calf-BR above age-stratified target range had significantly higher home BP, in spite of more antihypertensive treatments (p = 0.058). The patients who reached the target range of Calf-BR by decreasing DW, had their home BP significantly decreased, along with reduction in antihypertensive medications (p = 0.012).


CONCLUSIONS
Recognition and correction of chronic fluid overload based on age-stratified Calf-BR is helpful in hypertension control in Chinese HD patients.
Zhou
Yi-Lun
YL
Department of Nephrology, Chao-Yang Hospital, Capital Medical University, Beijing, China.
Liu
Jing
J
Sun
Fang
F
Ma
Li-Jie
LJ
Han
Bin
B
Shen
Yang
Y
Cui
Tai-Gen
TG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001794:Blood Pressure / Q000502:physiology*; D001823:Body Composition / Q000502:physiology; D001834:Body Water / Q000502:physiology; D017097:Electric Impedance; D045604:Extracellular Fluid / Q000502:physiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000517:prevention & control; D007676:Kidney Failure, Chronic / Q000628:therapy; D007866:Leg / Q000502:physiology; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods; D055815:Young Adult