title: Practical aspects of volume control in chronic kidney disease using whole body bioimpedance.
abstract: BACKGROUND
  Fluid status is an independent predictor of mortality in dialysis patients. Current methods of fluid assessment have several limitations.
  
  
  CONCLUSIONS
  An ideal method should be cheap, portable, easy to perform without extensive training, reproducible and determines patients' excess or deficit of total body water. Bioimpedance analysis (BIA) fulfils many of these criteria and can give additional information on fat and lean tissue composition. The accuracy and precision of BIA has been shown to be equivalent to the 'gold standard' direct estimation techniques.
  
  
  CONCLUSIONS
  Although there remains some concern about its validity in dialysis patients, fluid overload determined by BIA has been shown to predict mortality. BIA-guided fluid management appears superior to conventional fluid management in achieving clinically important outcomes such as reduction in blood pressure, left ventricular mass index, and arterial stiffness. Accurate setting of dry weight might also help preserve residual renal function by limiting episodes of dehydration. Nevertheless, as with all new technologies, there are issues that still need to be resolved. This will be achieved only with larger prospective interventional studies to explore its specific roles in dialysis cohorts.
authors: Department of Renal Medicine and Transplantation, Singapore General Hospital, Singapore, Singapore.
authors: Elizabeth L
authors: EL
authors: Oei
authors: Stanley L
authors: SL
authors: Fan
mesh_terms: D001794:Blood Pressure; D001823:Body Composition; D001826:Body Fluids; D001834:Body Water / Q000378:metabolism*; D001835:Body Weight; D017097:Electric Impedance; D006352:Heart Ventricles / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D006435:Renal Dialysis; D016019:Survival Analysis; D059289:Vascular Stiffness