title: The evaluation of filtration coefficients of microvasculature for the assessment of fluid  status in hemodialysis patients.
abstract: OBJECTIVE
  Bioimpedance spectroscopy (BIS) is widely used to assess fluid status in hemodialysis (HD) patients. Our purpose is to evaluate filtration coefficients (Lpst) as an alternative test to assess fluid status by utilizing BIS as a reference test.
  
  
  METHODS
  106 HD patients (determined group) were divided into two groups with (EX group: 53) or without excess fluid mass (ExF). ExF calculated from extracellular water and intracellular water measured by BIS. Multiple linear regression equation of Lpst was made using ExF (ExF/DW) and ultrafiltration rate (UFR/DW) to adjust Lpst (AdjLpst). The cut-off values of the tests for detection of EX were determined by receiver-operator characteristic curve analysis. Lpst, AdjLpst, serum atrial natriuretic peptide concentration (ANP), ultrasonically measured inferior vena cava diameter (IVCe/BSA), and blood volume change (Δ BV/TUF/DW) were examined. The detection abilities of these tests were evaluated in the distinct 61 patients (evaluated group).
  
  
  RESULTS
  Patients of the EX group numbered 29 in the evaluated group. The correlation between AdjLpst and ExF/DW was the highest. The sensitivity of AdjLpst and specificity of Lpst were the highest. The specificity of AdjLpst was equivalent to that of Lpst. Unadjusted and adjusted odds ratios of AdjLpst were the higher (20.80, 95% CI, 5.61-77.10, 16.06, 95% CI 4.00-64.59, respectively) than those of the other tests.
  
  
  CONCLUSIONS
  AdjLpst can detect patients of the EX group more accurately than other tests. Because AdjLpst is related to plasma refilling, it may indicate removable fluid overload. AdjLpst in conjunction with BIS may contribute to more adequate fluid management.
authors.affiliation: Division of Medical Engineering, Faculty of Medical Care Sciences, Himeji Dokkyo University, Hyogo, Japan 670-8524. yashiro@pearl.ocn.ne.jp
authors.forename: Masatomo
authors.initials: M
authors.lastname: Yashiro
authors.forename: Miyuki
authors.initials: M
authors.lastname: Ochiai
authors.forename: Nao
authors.initials: N
authors.lastname: Fujisawa
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kadoya
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kamata
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D009320:Atrial Natriuretic Factor / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001810:Blood Volume; D002199:Capillary Permeability; D017097:Electric Impedance; D005440:Fluid Therapy; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D016014:Linear Models; D016015:Logistic Models; D055806:Microvessels / Q000378:metabolism* / Q000503:physiopathology; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012372:ROC Curve; D006435:Renal Dialysis / Q000009:adverse effects; D013057:Spectrum Analysis; D014463:Ultrasonography; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging; D014882:Water-Electrolyte Balance; D014883:Water-Electrolyte Imbalance / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy
chemical_list: D015415:Biomarkers; D009320:Atrial Natriuretic Factor