title: Sensitivity of blood volume monitoring for fluid status assessment in hemodialysis patients.
abstract: OBJECTIVE
  This study investigates the use of blood volume monitoring (BVM) markers for the assessment of fluid status.
  
  
  METHODS
  Predialysis fluid overload (FO) and BVM data were collected in 55 chronic hemodialysis patients in 317 treatments. Predialysis FO was measured using bioimpedance spectroscopy. The slope of the intravascular volume decrease over time normalized by ultrafiltration rate (Slope4h) was used as the primary BVM marker and compared against FO.
  
  
  RESULTS
  Average relative blood volume curves were well separated in different FO groups between 0 and 5 liters. Receiver-operating characteristics analysis revealed that the sensitivity of BVM was moderate in median FO ranges between 1 and 3 liters (AUC 0.60-0.65), slightly higher for volume depletion of FO <1 liter (AUC 0.7) and highest for excess fluid of FO >3 liters (AUC 0.85).
  
  
  CONCLUSIONS
  Devices that monitor blood volume are well suited to detect high FO, but are not as sensitive at moderate or low levels of fluid status.
authors.affiliation: Department of Nephrology, Hospital Clinic Barcelona, Barcelona, Spain. fmaduell@clinic.ub.es
authors.forename: Francisco
authors.initials: F
authors.lastname: Maduell
authors.forename: Marta
authors.initials: M
authors.lastname: Arias
authors.forename: Elisabet
authors.initials: E
authors.lastname: Massó
authors.forename: Néstor
authors.initials: N
authors.lastname: Fontseré
authors.forename: Montserrat
authors.initials: M
authors.lastname: Carrera
authors.forename: Manel
authors.initials: M
authors.lastname: Vera
authors.forename: Aleix
authors.initials: A
authors.lastname: Cases
authors.forename: Josep M
authors.initials: JM
authors.lastname: Campistol
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000032:analysis; D001810:Blood Volume; D001811:Blood Volume Determination / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data*; D001823:Body Composition; D017097:Electric Impedance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data*; D012372:ROC Curve; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology*
chemical_list: D015415:Biomarkers