FP634HYDRATION STATUS EVALUATION BY LUNG COMETS, INFERIOR VENA CAVA DIAMETER AND BIOIMPENDANCE ANALYSIS BEFORE THE HEMODIAFILTRATION

Abstract

INTRODUCTION: Dry weight evaluation remains challenging in the end‐stage renal disease (ESRD) patients treated with the hemodiafiltration (HDF). Optimal hydration status (HS) is essential for preventing the incidence of the cardiovascular disease and death. The aim of our study was to assess HS before HDF with the lung ultrasound comets (LUC), inferior vena cava diameter (IVCD) and multifrequency bioimpedance spectroscopy (MBIS). METHODS: Forty‐eight HDF sessions in 12 randomly selected ESRD patients were analyzed. For LUC we used portable US device (Vscan, General Electrics Corporate), for IVCD portable US device (SonoSite, USA), and for MBIS Body Composition Monitor (Fresenius Medical Care, Bad Homburg, Germany). Evaluation of all three HS methods (LUC, IVCD, MBIS) was performed once a week for the four consecutive weeks before HDF. Ultrafiltration during HDF was not adjusted to the values of LUC, IVCD and MBIS. Overhydration (OH) was defined by IVCD as>11.5 mm/m2 and by MBIS as overhydration/extracellular water ratio (OH/ECW) >15%. Lung congestion was categorized as absent: <5 LUC; mild: ≥5 to <15 LUC; moderate: ≥15 to≥30 LUC; and severe: >30 LUC. OHby lung congestion was defined as>15 LUC. RESULTS: Descriptive data for all parameters are in table 1. Average values for all 4 weeks have shown OH before HDF by IVCD in 5 (41.7%) patients, by MBIS in 5 (41.7%) patients and by LUC in 4 (33.4%) patients. Four (33.3%) patients had mild, 2 (16.7%) patients moderate and 2 (16.7%) patients severe lung congestion. We found a positive correlation between MBIS and LUC (r=0.663; P=0.019), and between MBIS and IVCD (r=0.63; P=0.028) before HDF. We did not find any statistically significant correlation between IVCD and LUC before HDF. CONCLUSIONS: HS evaluation before HDF has shown that MBIS is associated with LUC and IVCD. The proportion ofOH patients before HDF was similar using LUC, MBIS or IVCD.