SP201BIOIMPEDANCE IN ACUTE RENAL FAILURE PROGNOSIS. PHASE ANGLE, NUTRITIONAL AND VOLEMIC PARAMETERS

Abstract

INTRODUCTION AND AIMS: Evaluate application of Bioimpedance (BIA) in acute kidny injury (AKI) prognosis. Implication of phase angle (PA), nutritional and volemic parameters. METHODS: We include a cohort of 180 patients (médium age 66 years SD 1.2, and male 73.3 %) with AKI and corporal BIA We evaluate bioelectrical parameters phase angle (PA) evaluate cellular membrane integrity), Extracellular/intracellular water ratio (ECW/ICW) evaluate extracellular edema), muscle/fat mass ratio (M/F) and celular mass idex (CMI) evaluate nutritional status, and clinical parameters and prognostic index (individual severity index-ISI-), analytical renal, inflammatory and nutritional parameters (Creatinine, C-reactive protein, albumin, prealbumin), days without optimal caloric balance (0, 1-3, 4-7 or> 7 days) and chronic health index (Karnofsky-K-, and ECOG). We use SPSS 20.0 RESULTS: Clinical prognostic index: ISI was associated with PA (r=-0.241, p=0.007) and ECW/ICW ratio (r=0.246, p=0.001) Clinical parameters. Oliguria was associated with higher ECW/ICW (p=0.021) (No: 1.40 SD 0.05 vs Yes: 1.68 SD 0.13), respiratory failure (p=0.006) (no: 1.42 SD 0.05, Low: 1.54 SD 0.82 y Serious: 2.33 SD 0.48). Hypotension with PA (p=0.027) (No: 4.09 SD 0.12 vs Yes: 3.57 SD 0.22), and ECW/ ICW (p=0.002) (No: 1.38 SD 0.05 vs Yes: 1.77 SD 0.14). Inspiratory volumen was associated with CMI (r=0.338, p=0.098). Analytical parameters: Protein metabolism: PA was associated with basal (r=0.396, p<0.001) and lower albumin (r=0.398, p<0.001).Inflammatory status: ECW/ICWwas associated with basal (r=0.260, p=0.001), higher C reactive protein (r=0.241, p=0.002) and ending C reactive protein (r=-0.372, p<0.001). PA with higher (r=-0.218, p=0.018) and ending C reactive protein (r=-0.341, p<0.001). Renal function CMI was associated with higher creatinine level (r=0.273, p=0.003). Non-optimal caloric balance: Was associated with CMI (p=0.029, r=-0.205), PA (p<0.001, r=-0.413) and ECW/ICW (p<0.001, r=0.396) Chronic health index: K was associated with PA (r=0.455, p<0.001) and ECW/ICW ratio (r=-0.1±51, p<0.001). ECOG with PA (r=-0.374, p<0.001) and ECW/ICW (r=-0.359, p<0.001). Mortality: Exitus 8.9%.PA was independently associated with mortality risk (OR 0.391, p=0.039 CI 95% 0.181-0.952). ROC curve area 0.775, p=0.001, CI 95% 0.6±3-0.887. CONCLUSIONS: BIA can be used to evaluate AKI prognosis. PA was associated with mortality risk, clinical and analytical parameters. ECW/ICW was associated with inflammatory status, oliguria and ARFmorbility. CMI with caloric balance and inspiratory capacity.