Skip to main content
Top
Published in: BMC Nephrology 1/2022

Open Access 01-12-2022 | Research

Consistency of the estimated target weights and ECW/TBW using BIA after hemodialysis in patients between standing and lying-down positions

Authors: Gwangho Choi, Ho Joong Yoon, Young Jin Song, Hae Min Jeong, Jae Eon Gu, Miyeun Han, Seok Hyung Kim, Jong-Woo Yoon, Hyunsuk Kim

Published in: BMC Nephrology | Issue 1/2022

Login to get access

Abstract

Background

As hemodialysis is administered with the patient lying down, the distribution of body fluid is stable in the lying position, which is why this position is recommended for bioimpedance analysis (BIA). Although the InBody S10 is widely used for hemodialysis patients in the lying position, clinicians must make the measurements in person. In contrast, patients can use the InBody 770 to obtain measurements by themselves in the standing position, which may be more convenient. Therefore, this study compared the measurements of hemodialysis patients’ estimated target weight and ECW/TBW obtained lying down using the S10 to those obtained in the standing position using the 770.

Methods

This study was conducted among maintenance hemodialysis patients at Chuncheon Sacred Heart Hospital in October 2020. Measurements from 56 patients before and after hemodialysis were obtained using the 2 machines. Each (S10 or 770) estimated target weight, both pre- and post-hemodialysis, was considered ideal when the ECW/TBW ratio was 0.380. R2 was calculated and the Bland-Altman test was performed.

Results

The patients’ median age was 64 years old, and 51% were men. The actual ultrafiltration was 2 kg, and the mean TBW change measured using the InBody devices was 1.5 L (R2 = 0.718) for the S10 and 1.7 L (R2 = 0.616) for the 770. The estimated target weight at pre- and post-hemodialysis showed a remarkably high correlation with the patients’ actual pre- and post-hemodialysis weight (R2 > 0.095). The correlation between these measurements (lying vs. standing) before and after hemodialysis was also very close (R2 = 1.0000). In addition, ECW/TBW had a good correlation (R2 ≥ 0.970) The Bland-Altman test of dry weight and ECW/TBW yielded similar results.

Conclusions

This study showed that patients’ estimated target weights in the lying position using the InBody S10 device and in the standing position using the InBody 770 device were consistent in both pre- and post-hemodialysis states.
Appendix
Available only for authorised users
Literature
1.
go back to reference Fürstenberg A, Davenport A. Assessment of body composition in peritoneal dialysis patients using bioelectrical impedance and dual-energy x-ray absorptiometry. Am J Nephrol. 2011;33(2):150–6.CrossRef Fürstenberg A, Davenport A. Assessment of body composition in peritoneal dialysis patients using bioelectrical impedance and dual-energy x-ray absorptiometry. Am J Nephrol. 2011;33(2):150–6.CrossRef
2.
go back to reference So W-Y, Swearingin B, Crooms B, Lee R, Choi Y, Dail TK, et al. Body composition measurements determined by air displacement plethysmography and eight-polar bioelectrical impedance analysis are equivalent in African American college students. Healthmed. 2012;6(6):1896–9. So W-Y, Swearingin B, Crooms B, Lee R, Choi Y, Dail TK, et al. Body composition measurements determined by air displacement plethysmography and eight-polar bioelectrical impedance analysis are equivalent in African American college students. Healthmed. 2012;6(6):1896–9.
3.
go back to reference Sartorio A, Malavolti M, Agosti F, Marinone P, Caiti O, Battistini N, et al. Body water distribution in severe obesity and its assessment from eight-polar bioelectrical impedance analysis. Eur J Clin Nutr. 2005;59(2):155–60.CrossRef Sartorio A, Malavolti M, Agosti F, Marinone P, Caiti O, Battistini N, et al. Body water distribution in severe obesity and its assessment from eight-polar bioelectrical impedance analysis. Eur J Clin Nutr. 2005;59(2):155–60.CrossRef
4.
go back to reference Utter AC, Lambeth PG. Evaluation of multifrequency bioelectrical impedance analysis in assessing body composition of wrestlers. Med Sci Sports Exerc. 2010;42(2):361–7.CrossRef Utter AC, Lambeth PG. Evaluation of multifrequency bioelectrical impedance analysis in assessing body composition of wrestlers. Med Sci Sports Exerc. 2010;42(2):361–7.CrossRef
5.
go back to reference Gibson AL, Holmes JC, Desautels RL, Edmonds LB, Nuudi L. Ability of new octapolar bioimpedance spectroscopy analyzers to predict 4-component–model percentage body fat in Hispanic, black, and white adults. Am J Clin Nutr. 2008;87(2):332–8.CrossRef Gibson AL, Holmes JC, Desautels RL, Edmonds LB, Nuudi L. Ability of new octapolar bioimpedance spectroscopy analyzers to predict 4-component–model percentage body fat in Hispanic, black, and white adults. Am J Clin Nutr. 2008;87(2):332–8.CrossRef
6.
go back to reference Kim H, Choi GH, Shim KE, Lee JH, Heo NJ, Joo K-W, et al. Changes in bioimpedance analysis components before and after hemodialysis. Kidney research and clinical practice. 2018;37(4):393.CrossRef Kim H, Choi GH, Shim KE, Lee JH, Heo NJ, Joo K-W, et al. Changes in bioimpedance analysis components before and after hemodialysis. Kidney research and clinical practice. 2018;37(4):393.CrossRef
7.
go back to reference Wizemann V, Wabel P, Chamney P, Zaluska W, Moissl U, Rode C, et al. The mortality risk of overhydration in haemodialysis patients. Nephrology Dialysis Transplantation. 2009;24(5):1574–9.CrossRef Wizemann V, Wabel P, Chamney P, Zaluska W, Moissl U, Rode C, et al. The mortality risk of overhydration in haemodialysis patients. Nephrology Dialysis Transplantation. 2009;24(5):1574–9.CrossRef
8.
go back to reference Abbas SR, Zhu F, Levin NW: Bioimpedance Can Solve Problems of Fluid Overload. Journal of Renal Nutrition (0). Abbas SR, Zhu F, Levin NW: Bioimpedance Can Solve Problems of Fluid Overload. Journal of Renal Nutrition (0).
9.
go back to reference Davies SJ, Davenport A. The role of bioimpedance and biomarkers in helping to aid clinical decision-making of volume assessments in dialysis patients. Kidney Int. 2014;86(3):489–96.CrossRef Davies SJ, Davenport A. The role of bioimpedance and biomarkers in helping to aid clinical decision-making of volume assessments in dialysis patients. Kidney Int. 2014;86(3):489–96.CrossRef
10.
go back to reference Yang EM, Park E, Ahn YH, Choi HJ, Kang HG, Cheong HI, et al. Measurement of fluid status using bioimpedance methods in Korean pediatric patients on hemodialysis. J Korean Med Sci. 2017;32(11):1828.CrossRef Yang EM, Park E, Ahn YH, Choi HJ, Kang HG, Cheong HI, et al. Measurement of fluid status using bioimpedance methods in Korean pediatric patients on hemodialysis. J Korean Med Sci. 2017;32(11):1828.CrossRef
11.
go back to reference Masuda T, Ohara K, Nagayama I, Matsuoka R, Murakami T, Nakagawa S, et al. Impact of serum albumin levels on the body fluid response to tolvaptan in chronic kidney disease patients. Int Urol Nephrol. 2019;51(9):1623–9.CrossRef Masuda T, Ohara K, Nagayama I, Matsuoka R, Murakami T, Nakagawa S, et al. Impact of serum albumin levels on the body fluid response to tolvaptan in chronic kidney disease patients. Int Urol Nephrol. 2019;51(9):1623–9.CrossRef
12.
go back to reference Brewer GJ, Blue MN, Hirsch KR, Saylor HE, Gould LM, Nelson AG, Smith-Ryan AE: Validation of InBody 770 bioelectrical impedance analysis compared to a four-compartment model criterion in young adults. Clin Physiol Funct Imaging 2021. Brewer GJ, Blue MN, Hirsch KR, Saylor HE, Gould LM, Nelson AG, Smith-Ryan AE: Validation of InBody 770 bioelectrical impedance analysis compared to a four-compartment model criterion in young adults. Clin Physiol Funct Imaging 2021.
13.
go back to reference Sato M, Inai K, Asagai S, Harada G, Shimada E, Sugiyama H. Skeletal muscle index determined by bioelectrical impedance analysis is a determinant of exercise capacity and a prognostic predictor in patients with congenital heart disease. J Cardiol. 2020;76(4):413–9.CrossRef Sato M, Inai K, Asagai S, Harada G, Shimada E, Sugiyama H. Skeletal muscle index determined by bioelectrical impedance analysis is a determinant of exercise capacity and a prognostic predictor in patients with congenital heart disease. J Cardiol. 2020;76(4):413–9.CrossRef
14.
go back to reference Shiba S, Chu P-S, Nakamoto N, Yamataka K, Taniki N, Ojiro K, et al. Clinical implications with tolvaptan on monitored bioimpedance-defined fluid status in patients with cirrhotic ascites: an observational study. BMC Gastroenterol. 2020;20(1):1–14.CrossRef Shiba S, Chu P-S, Nakamoto N, Yamataka K, Taniki N, Ojiro K, et al. Clinical implications with tolvaptan on monitored bioimpedance-defined fluid status in patients with cirrhotic ascites: an observational study. BMC Gastroenterol. 2020;20(1):1–14.CrossRef
15.
go back to reference Chung YJ, Kim EY. Usefulness of bioelectrical impedance analysis as a guidance of fluid Management in Critically ill Patients after major abdomen surgery; a single center, prospective cohort study. Surgical Metabolism and Nutrition. 2020;11(2):53–60.CrossRef Chung YJ, Kim EY. Usefulness of bioelectrical impedance analysis as a guidance of fluid Management in Critically ill Patients after major abdomen surgery; a single center, prospective cohort study. Surgical Metabolism and Nutrition. 2020;11(2):53–60.CrossRef
16.
go back to reference Levey AS, Eckardt K-U, Dorman NM, Christiansen SL, Hoorn EJ, Ingelfinger JR, et al. Nomenclature for kidney function and disease: report of a kidney disease: improving global outcomes (KDIGO) consensus conference. Kidney Int. 2020;97(6):1117–29.CrossRef Levey AS, Eckardt K-U, Dorman NM, Christiansen SL, Hoorn EJ, Ingelfinger JR, et al. Nomenclature for kidney function and disease: report of a kidney disease: improving global outcomes (KDIGO) consensus conference. Kidney Int. 2020;97(6):1117–29.CrossRef
17.
go back to reference Deurenberg P, Tagliabue A, Schouten FJ. Multi-frequency impedance for the prediction of extracellular water and total body water. Br J Nutr. 1995;73(3):349–58.CrossRef Deurenberg P, Tagliabue A, Schouten FJ. Multi-frequency impedance for the prediction of extracellular water and total body water. Br J Nutr. 1995;73(3):349–58.CrossRef
18.
go back to reference Sasaki N, Ueno K, Shiraishi T, Yoshimura A, Kuno M, Takeda SI, et al. The optimal ratio of extracellular water to total body water (ECW/TBW) determined by bioelectrical impedance analysis (BIA) for setting dry weight in hemodialysis patients. 日本透析医学会雑誌. 2008;41(10):723–30. Sasaki N, Ueno K, Shiraishi T, Yoshimura A, Kuno M, Takeda SI, et al. The optimal ratio of extracellular water to total body water (ECW/TBW) determined by bioelectrical impedance analysis (BIA) for setting dry weight in hemodialysis patients. 日本透析医学会雑誌. 2008;41(10):723–30.
19.
go back to reference Ohashi Y, Joki N, Yamazaki K, Kawamura T, Tai R, Oguchi H, et al. Changes in the fluid volume balance between intra-and extracellular water in a sample of Japanese adults aged 15–88 yr old: a cross-sectional study. Am J Physiol-Renal Physiol. 2018;314(4):F614–22.CrossRef Ohashi Y, Joki N, Yamazaki K, Kawamura T, Tai R, Oguchi H, et al. Changes in the fluid volume balance between intra-and extracellular water in a sample of Japanese adults aged 15–88 yr old: a cross-sectional study. Am J Physiol-Renal Physiol. 2018;314(4):F614–22.CrossRef
20.
go back to reference Bland JM, Altman D. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;327(8476):307–10.CrossRef Bland JM, Altman D. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;327(8476):307–10.CrossRef
21.
go back to reference Chamney PW, Wabel P, Moissl UM, Müller MJ, Bosy-Westphal A, Korth O, et al. A whole-body model to distinguish excess fluid from the hydration of major body tissues. Am J Clin Nutr. 2007;85(1):80–9.CrossRef Chamney PW, Wabel P, Moissl UM, Müller MJ, Bosy-Westphal A, Korth O, et al. A whole-body model to distinguish excess fluid from the hydration of major body tissues. Am J Clin Nutr. 2007;85(1):80–9.CrossRef
22.
go back to reference Kose SB, Hür E, Taskin H, Bicak S, Duman S. Volume status effected by gravity and body fluid shifts: new protocol for bioimpedance measurements. Ren Fail. 2014;36(10):1587–8.CrossRef Kose SB, Hür E, Taskin H, Bicak S, Duman S. Volume status effected by gravity and body fluid shifts: new protocol for bioimpedance measurements. Ren Fail. 2014;36(10):1587–8.CrossRef
23.
go back to reference Abbas SR, Zhu F, Levin NW. Bioimpedance can solve problems of fluid overload. J Ren Nutr. 2015;25(2):234–7.CrossRef Abbas SR, Zhu F, Levin NW. Bioimpedance can solve problems of fluid overload. J Ren Nutr. 2015;25(2):234–7.CrossRef
24.
go back to reference Kim HR, Bae HJ, Jeon JW, Ham YR, Na KR, Lee KW, et al. A novel approach to dry weight adjustments for dialysis patients using machine learning. PLoS One. 2021;16(4):e0250467.CrossRef Kim HR, Bae HJ, Jeon JW, Ham YR, Na KR, Lee KW, et al. A novel approach to dry weight adjustments for dialysis patients using machine learning. PLoS One. 2021;16(4):e0250467.CrossRef
25.
go back to reference Charra B, Laurent G, Chazot C, Calemard E, Terrat J-C, Vanel T, et al. Clinical assessment of dry weight. Nephrol Dialysis Transplant. 1996;11(supp2):16–9.CrossRef Charra B, Laurent G, Chazot C, Calemard E, Terrat J-C, Vanel T, et al. Clinical assessment of dry weight. Nephrol Dialysis Transplant. 1996;11(supp2):16–9.CrossRef
26.
go back to reference Cigarran S, Barril G, Cirugeda A, Bernis C, Aguilera A, Sanz P, et al. Hypoalbuminemia is also a marker of fluid excess determined by bioelectrical impedance parameters in dialysis patients. Ther Apher Dial. 2007;11(2):114–20.CrossRef Cigarran S, Barril G, Cirugeda A, Bernis C, Aguilera A, Sanz P, et al. Hypoalbuminemia is also a marker of fluid excess determined by bioelectrical impedance parameters in dialysis patients. Ther Apher Dial. 2007;11(2):114–20.CrossRef
27.
go back to reference Sasaki N, Ueno K, Shiraishi T, Yoshimura A, Kuno M, Takeda S. The optimal ratio of extracellular water to total body water (ECW/TBW) determined by bioelectrical impedance analysis (BIA) for setting dry weight in hemodialysis patients subtitle_in_Japanese. Nihon Toseki Igakkai Zasshi. 2008;41(10):723–30.CrossRef Sasaki N, Ueno K, Shiraishi T, Yoshimura A, Kuno M, Takeda S. The optimal ratio of extracellular water to total body water (ECW/TBW) determined by bioelectrical impedance analysis (BIA) for setting dry weight in hemodialysis patients subtitle_in_Japanese. Nihon Toseki Igakkai Zasshi. 2008;41(10):723–30.CrossRef
28.
go back to reference Spiegel D, Bashir K, Fisch B. Bioimpedance resistance ratios for the evaluation of dry weight in hemodialysis. Clin Nephrol. 2000;53(2):108–14.PubMed Spiegel D, Bashir K, Fisch B. Bioimpedance resistance ratios for the evaluation of dry weight in hemodialysis. Clin Nephrol. 2000;53(2):108–14.PubMed
29.
go back to reference Hecking M, Karaboyas A, Antlanger M, Saran R, Wizemann V, Chazot C, et al. Significance of interdialytic weight gain versus chronic volume overload: consensus opinion. Am J Nephrol. 2013;38(1):78–90.CrossRef Hecking M, Karaboyas A, Antlanger M, Saran R, Wizemann V, Chazot C, et al. Significance of interdialytic weight gain versus chronic volume overload: consensus opinion. Am J Nephrol. 2013;38(1):78–90.CrossRef
30.
go back to reference Hwang SD, Lee JH, Lee SW, Kim JK, Kim M-J, Song JH. Risk of overhydration and low lean tissue index as measured using a body composition monitor in patients on hemodialysis: a systemic review and meta-analysis. Ren Fail. 2018;40(1):51–9.CrossRef Hwang SD, Lee JH, Lee SW, Kim JK, Kim M-J, Song JH. Risk of overhydration and low lean tissue index as measured using a body composition monitor in patients on hemodialysis: a systemic review and meta-analysis. Ren Fail. 2018;40(1):51–9.CrossRef
31.
go back to reference Kim YJ, Jeon HJ, Kim YH, Jeon J, Ham YR, Chung S, et al. Overhydration measured by bioimpedance analysis and the survival of patients on maintenance hemodialysis: a single-center study. Kidney Res Clin Practice. 2015;34(4):212–8.CrossRef Kim YJ, Jeon HJ, Kim YH, Jeon J, Ham YR, Chung S, et al. Overhydration measured by bioimpedance analysis and the survival of patients on maintenance hemodialysis: a single-center study. Kidney Res Clin Practice. 2015;34(4):212–8.CrossRef
32.
go back to reference Covic A, Ciumanghel A-I, Siriopol D, Kanbay M, Dumea R, Gavrilovici C, et al. Value of bioimpedance analysis estimated “dry weight” in maintenance dialysis patients: a systematic review and meta-analysis. Int Urol Nephrol. 2017;49(12):2231–45.CrossRef Covic A, Ciumanghel A-I, Siriopol D, Kanbay M, Dumea R, Gavrilovici C, et al. Value of bioimpedance analysis estimated “dry weight” in maintenance dialysis patients: a systematic review and meta-analysis. Int Urol Nephrol. 2017;49(12):2231–45.CrossRef
33.
go back to reference Kim CR. Shin J-h, Hwang JH, Kim SH: monitoring volume status using bioelectrical impedance analysis in chronic hemodialysis patients. ASAIO J. 2018;64(2):245–52.CrossRef Kim CR. Shin J-h, Hwang JH, Kim SH: monitoring volume status using bioelectrical impedance analysis in chronic hemodialysis patients. ASAIO J. 2018;64(2):245–52.CrossRef
Metadata
Title
Consistency of the estimated target weights and ECW/TBW using BIA after hemodialysis in patients between standing and lying-down positions
Authors
Gwangho Choi
Ho Joong Yoon
Young Jin Song
Hae Min Jeong
Jae Eon Gu
Miyeun Han
Seok Hyung Kim
Jong-Woo Yoon
Hyunsuk Kim
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2022
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/s12882-022-02737-3

Other articles of this Issue 1/2022

BMC Nephrology 1/2022 Go to the issue