title: Calf bioimpedance spectroscopy for determination of dry weight in hemodialysis patients: effects on hypertension and left ventricular hypertrophy.
abstract: OBJECTIVE
  Dry weight estimation in hemodialysis patients is still a substantial problem. Despite meticulous clinical assessment, fluid overload is common, leading to hypertension and left ventricular hypertrophy (LVH). Segmental calf bioimpedance spectroscopy (cBIS) is a novel tool for dry weight assessment. Here we tested the hypothesis, that its clinical routine use reduces arterial hypertension and left ventricular mass.
  
  
  METHODS
  Left ventricular mass (determined by magnetic resonance imaging), blood pressure and antihypertensive medication (defined daily doses, ddd) were assessed at baseline (BL). Thereafter post-dialytic target weight was reduced until cBIS-defined dry weight was reached (DW). During a 6-month follow up, DW was re-evaluated monthly by cBIS and end-dialytic weight was adjusted correspondingly. At the end, left ventricular mass, blood pressure and antihypertensive medication were determined a 3rd time (follow-up, FU).
  
  
  RESULTS
  Eleven out of 15 patients were available for analysis after 6 months. Left ventricular mass showed a declining trend during the study period (Mean±SD; BL 145±54 g; DW 142±55 g; FU 137±52 g; p=0.61, linear mixed model). Comparable results were obtained for systolic blood pressure (BL 158±18 mmHg; DW 144±19 mmHg; FU 149±21 mmHg; p=0.07), and antihypertensive medication (BL 3.28±2.82ddd; DW 2.86±2.81ddd; FU 3.36±3.05ddd; p=0.37).
  
  
  CONCLUSIONS
  We conclude that attainment of dry weight assessed by cBIS tends to reduce left ventricular mass and blood pressure while antihypertensive medication remains unchanged. While the study was underpowered, its results provide an important hypothesis generating data basis for the design of larger studies.
authors.affiliation: Internal Medicine II, Martin-Luther-University Medical Centre, Halle, Germany. eric.seibert@medizin.uni-halle.de
authors.forename: Eric
authors.initials: E
authors.lastname: Seibert
authors.forename: Stephan G
authors.initials: SG
authors.lastname: Müller
authors.forename: Peter
authors.initials: P
authors.lastname: Fries
authors.forename: Johanna
authors.initials: J
authors.lastname: Pattmöller
authors.forename: Oliver
authors.initials: O
authors.lastname: Kuss
authors.forename: Gunnar H
authors.initials: GH
authors.lastname: Heine
authors.forename: Matthias
authors.initials: M
authors.lastname: Girndt
authors.forename: Günther
authors.initials: G
authors.lastname: Schneider
authors.forename: Peter
authors.initials: P
authors.lastname: Kotanko
authors.forename: Fansan
authors.initials: F
authors.lastname: Zhu
authors.forename: Nathan W
authors.initials: NW
authors.lastname: Levin
authors.forename: Martin K
authors.initials: MK
authors.lastname: Kuhlmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition / Q000502:physiology*; D001835:Body Weight / Q000502:physiology*; D058266:Dielectric Spectroscopy / Q000379:methods; D017097:Electric Impedance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D007866:Leg / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects; D016896:Treatment Outcome