Usefulness of bioimpedance spectroscopy for detection of hypotensive episode during dialysis.
Using statistical methods, this study investigates whether bioimpedance spectroscopy (BIS) and plasma electrolytes can be used to identify risk of intradialytic hypotension (IDH) based on information obtained during the first half of the dialysis treatment only. Data obtained from 40 patients included information on blood pressure, parameters defined from BIS, plasma electrolytes, and relevant clinical data. Patients were divided into three groups based on their intradialytic decrease in systolic blood pressure (SysBP) and associated symptoms and interventions: (1) Stable SysBP, (2) Asymptomatic unstable SysBP, and (3) symptomatic unstable SysBP. Retrospective analysis showed a significant reduction in extracellular fluid of 0.64 ± 0.62 L and potassium (K) concentration of 0.24 ± 1.67 mM in parallel with a decrease in SysBP of ≥25 mm Hg/hr. Data analysis using mixed-model procedure revealed that unstable patients compared with stable patients were characterized by higher extracellular resistance (p = 0.014) and K concentration (p = 0.009). Discriminant analysis using relative changes in extracellular resistance, potassium, and pH resulted in correct identification of 85% of the patients at risk. This study indicates that combining BIS and plasma electrolytes analysis may be a promising method to provide more accurate monitoring of IDH.
From the *Philips Chair for Medical Information Technology, RWTH Aachen University, Aachen, Germany; and †Department of Nephrology (Medical Clinic II), RWTH Aachen University Hospital, Aachen, Germany.
Abdul Hamid
AH
Ismail
Nadine
N
Trué
Theresa
T
Gross
Benjamin
B
Eilebrecht
Marian
M
Walter
Georg
G
Schlieper
Frank
F
Eitner
Jürgen
J
Floege
Steffen
S
Leonhardt
D000368:Aged; D000369:Aged, 80 and over; D058266:Dielectric Spectroscopy / Q000379:methods*; D004573:Electrolytes / Q000097:blood*; D005260:Female; D006801:Humans; D007022:Hypotension / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D014882:Water-Electrolyte Balance / Q000502:physiology
D004573:Electrolytes