A tool for establishing dry weight in hemodialysis patients. All patients?

Abstract

The BCM (Body Composition Monitor) is a potential diagnostic tool based on bioimpedance spectroscopy to evaluate body composition. This technique is now commonly used. It was validated in healthy people with the reference methods to estimate the compartiments of water, lean and fat mass and body cell mass. However, it remains still difficult to evaluate body composition and fluid changes in patients before, during and after hemodyalisis. It is of great importance to achieve this goal because a bad hydration state may lead to severe problems. BCM is a possible way to investigate and to diagnose over hydration state. We have used a commercial device to to follow hydration state before and after dialysis sessions, in ten chronic hemodialysis patients over 80 years old. In this paper we are interested by the difficulties induced by patient's specificities. Two of them presented particularities : one has an implanted pace-maker and another one a double hip prosthesis. We compared the measures of the BCM and the real values of the sessions and tried to identify the factors of the differences between them. The results allowed us to identify and classify different groups of patients. This preliminary results (the measurement campaign being still on the way) confirmed that using BIS to follow the evolution of dry weight must be based on a subtle analysis of the patient's specificities especially for old ones. Different groups of patients could thus be defined according to their characteristics and to identified related influencing parameters This preliminary results is a first step in defining a guideline for using BIS for old patient's dry weight determination. © 2009 Springer-Verlag.