Issn Print: 1058-2916
Publication Date: 2004/03/01
MODELING OF SBIA DATA REFLECTING FLUID KINETICS IN THE CALF DURING HEMODIALYSIS
F. Zhu; E. F. Leonard; M. K. Kuhlmann; N. W. Levin
+ Author Information
Author Information: Renal Research Institute and, Beth Israel Medical Center, New York, NY, United States
Excerpt
Segmental body impedence (SBI) data from the calfs of hemodialysis patients have the potential to track intradialytic fluid transfer and to specify a less subjective end-dialysis (“dry”) weight. One can obtain the time course of the resistance of extracellular fluid in a defined segment, Re(t), from Cole-Cole analysis. Assuming a fixed geometry and specific resistance of the extracellular fluid the fractional volume, Ve(t)/Ve(0) equals Re(0)/Re(t). Plots of this quantity vs, time indicate bi-exponential behavior [Ve(t)/Ve(0) = A exp(-Bt) + Cexp(Dt)] and a steadily decreasing rate of change in Ve, We define dry weight as the weight at which Ve(t)/Ve(0) inferred from SB I does not change by more than 1% in 20 min. We analyze data taken from patients dialyzed to this dry weight (ADW) in comparison to their previous sessions in which they were dialyzed to a dry weight specified by clinical signs (CDW) -as shown in Table 1. We interpret the model as a volume-driven flow of fluid from an extravascular interstitial volume into the extracellular space of the perfusing blood. We will show that use of ADW gives a significant drop in pre-dialysis patient weight.
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